{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:51:57Z","timestamp":1777420317936,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T00:00:00Z","timestamp":1727481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A protocol was established for ventilator-associated tracheitis or pneumonia using inhaled tobramycin 300 mg every 12 hours in mechanically ventilated children via a vibrating mesh nebulizer, 30 cm from the endotracheal tube in the inspiratory loop of the mechanical ventilator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The primary objective was to determine the incidence of detectable tobramycin trough concentrations &gt;0.5 \u00b5g\/mL. Secondary objectives included a comparison of clinical characteristics between those with and without detectable concentrations and identification of patients with acute kidney injury (AKI) as defined by the Kidney Diseases Improving Global Outcomes (KDIGO) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a single-center retrospective study of critically ill children &lt;18 years without cystic fibrosis receiving inhaled tobramycin between July 1, 2016, and August 31, 2021. Data collection included demographics, tobramycin regimen, and renal function. Analysis was performed using SAS 9.4, with a\n                      <jats:italic>P<\/jats:italic>\n                      -value &lt;0.05, and a multivariable regression model was performed to identify factors for detectable concentrations and AKI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-four patients (66 courses) were included, with an overall age of 0.83 years. Thirty (68%) patients had detectable concentrations and 9 (20.5%) developed AKI. No significant differences in demographics, diagnosis, mechanical ventilation settings, and number of nephrotoxins were noted between those with and without detectable concentrations or AKI. Multivariable regressions did not identify factors associated with detectable concentrations or AKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Relevance:<\/jats:title>\n                    <jats:p>Detectable concentrations occurred with the majority of courses, with AKI associated with approximately one-fourth of courses. Clinicians should consider utilizing trough monitoring for all mechanically ventilated critically ill children receiving inhaled tobramycin.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280241282433","type":"journal-article","created":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T01:26:51Z","timestamp":1727573211000},"page":"430-438","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Detectable Concentrations With Inhaled Tobramycin in Critically Ill Infants and Children Following Implementation of Standardized Protocol"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3022-4403","authenticated-orcid":false,"given":"Peter N.","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenie","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Bethany Children\u2019s Health Center, Bethany, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Cormack","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Banner\u2014University Health Center Tucson, Tucson, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaley","family":"Hornaday","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, INTEGRIS Baptist Medical Center, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen B.","family":"Neely","sequence":"additional","affiliation":[{"name":"Office of Instruction, Assessment, &amp; Faculty\/Staff Development, College of Pharmacy, The University of Oklahoma, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Ranallo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Critical Care, College of Medicine, The University of Oklahoma, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hala","family":"Chaaban","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Neonatology, College of Medicine, The University of Oklahoma, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucila","family":"Garcia-Contreras","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2637-2550","authenticated-orcid":false,"given":"Jamie L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-3686"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.6.562"},{"key":"e_1_3_3_5_2","volume-title":"Tobramycin monograph (Lexi-Comp OnlineTM, Pediatric Lexi-Drugs OnlineTM)","year":"2024","unstructured":"Tobramycin monograph (Lexi-Comp OnlineTM, Pediatric Lexi-Drugs OnlineTM). 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