Renal and respiratory tolerance of aerosolized tobramycin in intubated andmechanically ventilated patients with nosocomial pneumonia: a preliminary study

OBJECTIVE: The aim of this study was to assess renal and respiratory tolera nce of aerosolized tobramycin in intubated and mechanically ventilated pati ents with nosocomial pneumonia. PATIENTS AND METHODS: This was a multicenter, randomized, double-blind plac ebo controlled study. Thirty-eight mechanically ventilated patients with do cumented nosocomial pneumonia were included. Patients treated with intraven ous betalactam and tobramycin were randomly allocated to receive aerosolize d tobramycin (6 mg/kg/day, n = 21) or placebo (n = 17). The aerosol was adm inistered via a pneumatic nebulizer once a day for 5 days. RESULTS: Respiratory tolerance was good in ail but two patients. No acute r enal failure occurred. By day 10, 7 patients in the tobramycin group (35%) had been extubated versus 3 in the placebo group (18.5% p = 0.18). By day 2 8, 6 patients had died (2 in the tobramycin group and 4 in the placebo grou p, p = 0.23). CONCLUSION: Aerosolized tobramycin was well tolerated in ventilated patient s with documented nosocomial pneumonia.