Abstract
Broth dilution susceptibility tests of 100 isolates of Pseudomonas aeruginosa and 101 isolates of Staphylococcus aureus against tobramycin (formerly nebramycin factor 6) and gentamicin showed that tobramycin was more effective against P. aeruginosa and less effective against S. aureus. The minimal inhibitory concentration of tobramycin against the Pseudomonas sp. isolates that required 5 μg of gentamicin per ml for inhibition ranged from 0.63 to 0.31 μg/ml. Peak concentrations in the blood of 10 healthy adults after intramuscular injection of 80 and 40 mg of tobramycin averaged 3.7 ± 0.62 and 2.4 ± 0.27 μg/ml, and declined to 0.56 ± 0.05 and 0.26 ± 0.02 μg/ml, respectively, after 6 h. The urine recovery averaged 60%. The half-life was 1.6 h. During continuous intravenous infusion of tobramycin and gentamicin (infusion rate 6.6 mg per h), blood levels at steady state were 0.94 ± 0.10 and 1.04 ± 0.06 μg/ml, respectively. For both antibiotics, the calculated distribution volume ranged from 15 to 17 liters. The renal clearance to tobramycin averaged 76% and that of gentamicin averaged 85% of the total clearance, indicating that the drugs are primarily eliminated by the kidneys. The present results suggest that tobramycin may be more successful in the treatment of Pseudomonas infections than gentamicin at the same dosage (80 mg intramuscularly three to four times daily).
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BULGER R. J., SIDELL S., KIRBY W. M. LABORATORY AND CLINICAL STUDIES OF GENTAMICIN, A NEW BROAD-SPECTRUM ANTIBIOTIC. Ann Intern Med. 1963 Nov;59:593–604. doi: 10.7326/0003-4819-59-5-593. [DOI] [PubMed] [Google Scholar]
- Black H. R., Griffith R. S. Preliminary studies with nebramycin factor 6. Antimicrob Agents Chemother (Bethesda) 1970;10:314–321. [PubMed] [Google Scholar]
- Cox C. E. Gentamicin, a new aminoglycoside antibiotic: clinical and laboratory studies in urinary tract infection. J Infect Dis. 1969 Apr-May;119(4):486–491. doi: 10.1093/infdis/119.4-5.486. [DOI] [PubMed] [Google Scholar]
- Darrell J. H., Waterworth P. M. Dosage of gentamicin for pseudomonas infections. Br Med J. 1967 May 27;2(5551):535–537. doi: 10.1136/bmj.2.5551.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Federspil P. Clinical use of gentamicin in ear, nose, and throat infections. J Infect Dis. 1969 Apr-May;119(4):465–470. doi: 10.1093/infdis/119.4-5.465. [DOI] [PubMed] [Google Scholar]
- Gehler J., Kübler W. Verteilungsstudien mit intravenös infundierter Ascorbinsäure. Int Z Vitaminforsch. 1970;40(4):454–464. [PubMed] [Google Scholar]
- Gingell J. C., Chisholm G. D., Calnan J. S., Waterworth P. M. The dose, distribution, and excretion of gentamicin with speical reference to renal failure. J Infect Dis. 1969 Apr-May;119(4):396–401. doi: 10.1093/infdis/119.4-5.396. [DOI] [PubMed] [Google Scholar]
- Higgins C. E., Kastner R. E. Nebramycin, a new broad-spectrum antibiotic complex. II. Description of Streptomyces tenebrarius. Antimicrob Agents Chemother (Bethesda) 1967;7:324–331. [PubMed] [Google Scholar]
- Holt R. J., Newman R. L. Gentamicin in urinary infections of children. Arch Dis Child. 1968 Jun;43(229):329–333. doi: 10.1136/adc.43.229.329. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KRUEGER-THIEMER E., SCHLENDER B., SEYDEL J. DIE LOESUNG CHEMOTHERAPEUTISCHER PROBLEME DURCH PROGRAMMGESTEUERTE ZIFFERNRECHENAUTOMATEN. 3. DIE BERECHNUNG DER BASALLOESLICHKEIT SO UND DER SAUREN PKA'-WERTE PON SULFANILAMIDEN NACH DER LOESLICHKEITSGLEICHUNG PON KREBS UND SPEAKMAN. Arzneimittelforschung. 1963 Oct;13:894–906. [PubMed] [Google Scholar]
- Koch K. F., Rhoades J. A. Structure of nebramycin factor 6, a new aminoglycosidic antibiotic. Antimicrob Agents Chemother (Bethesda) 1970;10:309–313. [PubMed] [Google Scholar]
- Nunnery A. W., Riley H. D., Jr Gentamicin: clinical and laboratory studies in infants and children. J Infect Dis. 1969 Apr-May;119(4):460–464. doi: 10.1093/infdis/119.4-5.460. [DOI] [PubMed] [Google Scholar]
- Preston D. A., Wick W. E. Preclinical assessment of the antibacterial activity of nebramycin factor 6. Antimicrob Agents Chemother (Bethesda) 1970;10:322–327. doi: 10.1128/AAC.10.2.322. [DOI] [PubMed] [Google Scholar]
- Reutter F. W., Modde H. Klinische Erfahrungen mit Gentamicin in der Behandlung von Harnwegsinfekten. Ther Umsch. 1969 Jan;(Suppl):32–35. [PubMed] [Google Scholar]
- SWEEDLER D. R., GRAVENKEMPER C. F., BULGER R. J., BRODIE J. L., KIRBY W. M. LABORATORY AND CLINICAL STUDIES OF GENTAMICIN. Antimicrob Agents Chemother (Bethesda) 1963;161:157–160. [PubMed] [Google Scholar]
- Stark W. M., Hoehn M. M., Knox N. G. Nebramycin, a new broad-spectrum antibiotic complex. I. Detection and biosynthesis. Antimicrob Agents Chemother (Bethesda) 1967;7:314–323. [PubMed] [Google Scholar]
- Thompson R. Q., Presti E. A. Nebramycin, a new broad-spectrum antibiotic complex. 3. Isolation and chemical-physical properties. Antimicrob Agents Chemother (Bethesda) 1967;7:332–340. [PubMed] [Google Scholar]
- Urlesberger H., Zechner E. Klinische Erfahrungen bei chronischen Harnwegsinfekten mit Gentamycin. Wien Med Wochenschr. 1969 Nov 1;119(44):755–756. [PubMed] [Google Scholar]
- WEINSTEIN M. J., LUEDEMANN G. M., ODEN E. M., WAGMAN G. H., ROSSELET J. P., MARQUEZ J. A., CONIGLIO C. T., CHARNEY W., HERZOG H. L., BLACK J. GENTAMICIN, A NEW ANTIBIOTIC COMPLEX FROM MICROMONOSPORA. J Med Chem. 1963 Jul;6:463–464. doi: 10.1021/jm00340a034. [DOI] [PubMed] [Google Scholar]
- Wick W. E., Welles J. S. Nebramycin, a new broad-spectrum antibiotic complex. IV. In vitro and in vivo laboratory evaluation. Antimicrob Agents Chemother (Bethesda) 1967;7:341–348. doi: 10.1128/AAC.7.3.341. [DOI] [PubMed] [Google Scholar]
- von Kobyletzki D., Wahlig H., Gebhardt F. Zur Pharmakokinetik von Gentamycin im Serum und Harn. Med Klin. 1969 Aug 22;64(34):1497–1502. [PubMed] [Google Scholar]