Clinical Study of the Use of the New Aminoglycoside Tobramycin for Therapy of Infections Due to Gram-Negative Bacteria

Abstract

Tobramycin, a new aminoglycoside antimicrobial, was evaluated as therapy for infections due to gram-negative bacilli in 15 seriously ill patients with underlying diseases. Three of 10 patients with gram-negative bacteremias also had urinary tract infections. Two patients had respiratory tract infections, one had cellulitis, one had a urinary tract infection, and another had septic phlebitis. Twelve patients were cured of their infections. Eosinophilia was observed in one patient and another developed superinfection with Staphylococcus aureus after 6 days of tobramycin therapy. There were five isolates of Escherichia coli , five of Klebsiella sp., two of Pseudomonas sp., and one each of Enterobacter agglomerans, Serratia marcescens , and Enterobacter cloacae . The average serum concentration of tobramycin 2 h after a parenteral dose of 1.0 to 1.5 mg/kg was 5.1 μg/ml; higher concentrations of tobramycin were present in urine. Tobramycin proved to be an effective antimicrobial in these patients.