{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:23:07Z","timestamp":1777504987380,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>There is a renewed interest in the successful use of aminoglycosides due to increasing resistance in gram-negative infections. Few studies to date have examined the pharmacokinetics (PK) of intradialytic infusions of tobramycin. This study sought to characterize the pharmacokinetic profile of intradialytically administered tobramycin in infected patients receiving chronic intermittent hemodialysis and to determine whether it is possible to achieve favorable PK targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, Participants, and Measurements:<\/jats:title>\n                    <jats:p>In this prospective pharmacokinetic study, a single dose (5 mg\/kg) of tobramycin was administered intradialytically to 11 noncritically ill patients undergoing chronic intermittent hemodialysis. Blood samples were collected at selected time to determine tobramycin serum concentrations. The PK analysis was performed using Phoenix\u2122 NLME. The efficacy exposure outcome for nonsevere gram-negative infections sensitive to tobramycin with a minimum inhibitory concentration \u22641 were maximum concentration (Cmax \u2265 10 mg\/L) and area under the curve (AUC24 h &gt; 30 mg\u22c5h\/L). For toxicity, the goal was to identify plasma trough concentrations &lt;2 mg\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Tobramycin disposition was best described by a one-compartment model using a total clearance composed of the systemic clearance and a transitory hemodialysis clearance. Tobramycin mean (SD) C\n                      <jats:sub>max<\/jats:sub>\n                      , trough levels, and AUC\n                      <jats:sub>24h<\/jats:sub>\n                      were 13.1 (1.3) mg\/L, 1.32 (0.47) mg\/L, and 61 (23) mg\u22c5h\/L, respectively. Monte Carlo simulation run with 1000 virtual patients showed that a 5 mg\/kg dose of tobramycin administered intradialytically can outperformed the usual low-dose postdialysis dosing (80% meeting all targets versus &lt;1%, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A single high dose of tobramycin can achieve favorable PK outcome when administered using intradialytic infusions in hemodialysis patients. This practical dosing regimen may represent an effective and safer alternative to the usual dosing in the treatment of nonsevere gram-negative infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2054358120987061","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T04:31:36Z","timestamp":1613881896000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Pharmacokinetics of Tobramycin Administered at the Beginning of Intermittent Hemodialysis Session (ESRD Study)"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1034-8161","authenticated-orcid":false,"given":"Marjolaine","family":"Giroux","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anik","family":"Henderson","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesly","family":"Lam","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Van Anh Sylvie","family":"Tran","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Projean","sequence":"additional","affiliation":[{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Fran\u00e7ois","family":"Tessier","sequence":"additional","affiliation":[{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Lepage","sequence":"additional","affiliation":[{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Gavra","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georges","family":"Ouellet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"Service de N\u00e9phrologie, H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Vall\u00e9e","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, QC, Canada"},{"name":"Service de N\u00e9phrologie, H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Philippe","family":"Lafrance","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Maisonneuve-Rosemont, Centre int\u00e9gr\u00e9 universitaire de sant\u00e9 et de services sociaux de l\u2019Est-de-l\u2019\u00cele-de-Montr\u00e9al, QC, Canada"},{"name":"Centre de recherche de l\u2019H\u00f4pital Maisonneuve-Rosemont, Montr\u00e9al, QC, Canada"},{"name":"D\u00e9partement de pharmacologie et physiologie, Universit\u00e9 de Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"bibr1-2054358120987061","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.07.013"},{"key":"bibr2-2054358120987061","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00950208"},{"key":"bibr3-2054358120987061","unstructured":"Center for Disease Control and Prevention. 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