Penetration of gentamicin into lung tissues

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Antibiotic penetration into lung tissues.

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Antibiotic penetration into lung tissues.

Optimal dosing for nebulized gentamicin is unknown. We compared the pulmonary and systemic pharmacokinetics PK of gentamicin following intravenous and nebulized administration in mechanically ventilated patients. The PK analysis was conducted using a population approach. After intravenous administration, concentrations of gentamicin measured in epithelial lining fluid ELF were very variable, and overall in the same range of magnitude from 0. Compared with intravenous administration, after nebulization the exposure expressed as AUC to gentamicin was fold greater in ELF and fold lower in plasma. Compared with intravenous administration, nebulization of gentamicin in patients with ventilator-associated pneumonia provides higher pulmonary concentrations and lower systemic concentrations but the inter-individual variability is large.
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Study objectives: To estimate the penetration of gentamicin into lung tissue by measuring its concentrations in alveolar lining fluid ALF and blood in critically ill patients with ventilator-associated pneumonia VAP. Patients and interventions: The study population consisted of 24 patients who were admitted to an ICU for respiratory failure and developed VAP. Patients were scheduled to undergo bronchoscopy with BAL after IV administration of a once-daily, mg schedule of gentamicin for the treatment of VAP.
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