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Article

Evaluation of Target Attainment for Tobramycin in Children and Adults with Cystic Fibrosis

by
Sheseira T. L. Struiken
1,†,
Danique Lobée
1,†,
Eline L. van Tuinen
1,†,
Daniel J. Touw
1,2,
Hester van der Vaart
3,
Arno R. Bourgonje
4,5,
Bart L. Rottier
6,7,
Gerard H. Koppelman
6,7 and
Paola Mian
1,*
1
Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, 9712 GZ Groningen, The Netherlands
2
Department of Pharmaceutical Analysis, Groningen Research Institute for Pharmacy, University of Groningen, 9712 GZ Groningen, The Netherlands
3
Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, 9712 GZ Groningen, The Netherlands
4
Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9712 GZ Groningen, The Netherlands
5
Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
6
Department of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, Beatrix Children’s Hospital, University of Groningen, 9712 GZ Groningen, The Netherlands
7
Department of Pediatric Pulmonology, University Medical Center Groningen, University of Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), 9712 GZ Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2024, 13(9), 2641; https://doi.org/10.3390/jcm13092641
Submission received: 3 February 2024 / Revised: 19 April 2024 / Accepted: 22 April 2024 / Published: 30 April 2024
(This article belongs to the Section Infectious Diseases)
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Abstract

Introduction: Patients with cystic fibrosis (CF) commonly experience pulmonary exacerbations, and it is recommended by the TOPIC study to treat this with tobramycin at a dose of 10 mg/kg once daily. The aim of this study was to evaluate the target attainment of the current dosing regimen. Methods: A single-center retrospective cohort study of child and adult patients with CF who received tobramycin between 2019 and 2022 was conducted. Descriptive statistics and linear mixed models were used to assess target attainment for tobramycin. Results: In total, 25 patients (53 courses), of which 10 were children (12 courses) and 15 were adults (41 courses), were included. Those 25 patients all received 10 mg/kg/day. The tobramycin peak concentrations were supratherapeutic in 82.9% and therapeutic in 100.0% of adults and children, respectively. The trough concentrations were outside the target range in 0% and 5.1% of children and adults, respectively. We found lower tobramycin concentrations with the same dose in children compared to adults. Conclusions: This study illustrates the need to validate dosing advice in a real-world setting, as supratherapeutic concentrations of tobramycin were prevalent in adults with CF.
Keywords: tobramycin; pharmacokinetics; cystic fibrosis; therapeutic drug monitoring tobramycin; pharmacokinetics; cystic fibrosis; therapeutic drug monitoring

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MDPI and ACS Style

Struiken, S.T.L.; Lobée, D.; Tuinen, E.L.v.; Touw, D.J.; Vaart, H.v.d.; Bourgonje, A.R.; Rottier, B.L.; Koppelman, G.H.; Mian, P. Evaluation of Target Attainment for Tobramycin in Children and Adults with Cystic Fibrosis. J. Clin. Med. 2024, 13, 2641. https://doi.org/10.3390/jcm13092641

AMA Style

Struiken STL, Lobée D, Tuinen ELv, Touw DJ, Vaart Hvd, Bourgonje AR, Rottier BL, Koppelman GH, Mian P. Evaluation of Target Attainment for Tobramycin in Children and Adults with Cystic Fibrosis. Journal of Clinical Medicine. 2024; 13(9):2641. https://doi.org/10.3390/jcm13092641

Chicago/Turabian Style

Struiken, Sheseira T. L., Danique Lobée, Eline L. van Tuinen, Daniel J. Touw, Hester van der Vaart, Arno R. Bourgonje, Bart L. Rottier, Gerard H. Koppelman, and Paola Mian. 2024. "Evaluation of Target Attainment for Tobramycin in Children and Adults with Cystic Fibrosis" Journal of Clinical Medicine 13, no. 9: 2641. https://doi.org/10.3390/jcm13092641

APA Style

Struiken, S. T. L., Lobée, D., Tuinen, E. L. v., Touw, D. J., Vaart, H. v. d., Bourgonje, A. R., Rottier, B. L., Koppelman, G. H., & Mian, P. (2024). Evaluation of Target Attainment for Tobramycin in Children and Adults with Cystic Fibrosis. Journal of Clinical Medicine, 13(9), 2641. https://doi.org/10.3390/jcm13092641

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