{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T14:02:17Z","timestamp":1756994537669,"version":"3.44.0"},"reference-count":22,"publisher":"The Pediatric Pharmacy Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016]]},"abstract":"\n OBJECTIVES:<\/jats:bold> Survey suggests that recommended doses and dosage regimens for antipseudomonal antibiotics for the treatment of acute pulmonary exacerbations in cystic fibrosis (CF) patients are not used, and one way to address these disparities is the involvement of pharmacists who are dedicated to CF. This is the first survey specifically designed for pharmacists at Cystic Fibrosis Foundation (CFF)\u2013accredited centers to identify how tobramycin and antipseudomonal beta-lactams are being used. The purpose of this survey is to quantify this information and to promote future study to allow for implementation of tobramycin and beta-lactam dosage and monitoring standardization.<\/jats:p>\n \n METHODS:<\/jats:bold> An anonymous national cross-sectional survey of pharmacists that are affliated with CFF-accredited programs was performed using Qualtrics.com<\/jats:ext-link>.<\/jats:p>\n \n RESULTS:<\/jats:bold> The survey had a 48.5% response rate. Most pediatric pharmacists (78.6%) report using extended-interval tobramycin dosage. The most common reported starting dosage was 10 mg\/kg every 24 hours; most centers aim for a maximum serum concentration (Cmax<\/jats:sub>) between 20 and 40 mg\/L (78.6%). A total of 26 adult pharmacists reported using extended-interval dosage (96%), using an initial dosage of 10 mg\/kg\/day. The most common parameters used to adjust dosage were Cmax<\/jats:sub> and area under the curve (AUC; 31%); the Cmax<\/jats:sub> goal was 20 to 40 mg\/L (84.2%). Most respondents (79%) report using beta-lactams in combination with tobramycin. Extended-infusion and continuous-infusion beta-lactams were used more in adults than pediatric patients.<\/jats:p>\n \n CONCLUSIONS:<\/jats:bold> Most CF pharmacists report using extended-interval tobramycin. With the information from this survey, the establishment of future consensus recommendations by pharmacists for optimal and consistent tobramycin and antipseudomonal beta-lactam dosage and monitoring strategies needs to be considered.<\/jats:p>","DOI":"10.5863\/1551-6776-21.3.239","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T18:47:56Z","timestamp":1469040476000},"page":"239-246","source":"Crossref","is-referenced-by-count":5,"title":["Tobramycin and Beta-Lactam Antibiotic Use in Cystic Fibrosis Exacerbations: A Pharmacist Approach"],"prefix":"10.5863","volume":"21","author":[{"given":"Jeffery T.","family":"Zobell","sequence":"first","affiliation":[{"name":"Intermountain Primary Children's Hospital, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Epps","sequence":"additional","affiliation":[{"name":"St. Vincent's Hospital Riverside, Jacksonville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Kittell","sequence":"additional","affiliation":[{"name":"University of Wisconsin Hospital, Madison, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarissa","family":"Sema","sequence":"additional","affiliation":[{"name":"University of Arizona, Tucson, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin J.","family":"McDade","sequence":"additional","affiliation":[{"name":"Texas Children's Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacy J.","family":"Peters","sequence":"additional","affiliation":[{"name":"Sanford Medical Center, Sioux Falls, South Dakota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariela A.","family":"Duval","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca S.","family":"Pettit","sequence":"additional","affiliation":[{"name":"Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"3","key":"i1551-6776-21-3-239-b1","series-title":"N Engl J Med","first-page":"179","article-title":"Management of pulmonary disease in patients with cystic fibrosis","volume":"335","year":"1996","unstructured":"Ramsey\n BW.\n \n \n Management of pulmonary disease in patients with cystic fibrosis. N Engl J Med. 1996;335(3):179\u2013188."},{"issue":"8","key":"i1551-6776-21-3-239-b2","series-title":"Am J Respir Crit Care Med","first-page":"918","article-title":"Pathophysiology and management of pulmonary infections in cystic fibrosis","volume":"168","year":"2003","unstructured":"Gibson\n RL, \n \n Burns\n JL, \n \n Ramsey\n BW.\n \n \n Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med. 2003;168(8):918\u2013951."},{"issue":"10","key":"i1551-6776-21-3-239-b3","series-title":"Am J Respir Crit Care Med","first-page":"957","article-title":"Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health","volume":"176","year":"2007","unstructured":"Flume\n PA, \n \n O'Sullivan\n BP, \n \n Robinson\n KA, \n \n et al. Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health. 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Accessed May 19, 2016."},{"issue":"suppl 1","key":"i1551-6776-21-3-239-b12","series-title":"J Cyst Fibros","first-page":"S3","article-title":"European cystic fibrosis society standards of care: framework for the cystic fibrosis centre","volume":"13","year":"2014","unstructured":"Conway\n S, \n \n Balfour-Lynn\n IM, \n \n De Rijcke\n K, \n \n et al. European cystic fibrosis society standards of care: framework for the cystic fibrosis centre. J Cyst Fibros. 2014;13(suppl 1):S3\u2013S22."},{"issue":"S36","key":"i1551-6776-21-3-239-b13","series-title":"Pediatr Pulmonol","first-page":"39","article-title":"A survey of the pharmacist's role at US CFF-accredited centers-a director's perspective","volume":"48","year":"2013","unstructured":"Bhakta\n ZN, \n \n Young\n DC, \n \n Zobell\n JT, \n \n et al. A survey of the pharmacist's role at US CFF-accredited centers-a director's perspective. Pediatr Pulmonol. 2013;48(S36):39."},{"issue":"4","key":"i1551-6776-21-3-239-b14","series-title":"J Antimicrob Chemother","first-page":"822","article-title":"Once-daily tobramycin in cystic fibrosis: better for clinical outcome than thrice-daily tobramycin but more resistance development?","volume":"58","year":"2006","unstructured":"Burkhardt\n O, \n \n Lehmann\n C, \n \n Madabushi\n R, \n \n et al. Once-daily tobramycin in cystic fibrosis: better for clinical outcome than thrice-daily tobramycin but more resistance development?J Antimicrob Chemother. 2006;58(4):822\u2013829."},{"issue":"6","key":"i1551-6776-21-3-239-b15","series-title":"Arch Dis Child","first-page":"536","article-title":"Efficacy, tolerance, and pharmacokinetics of once daily tobramycin for pseudomonas exacerbations in cystic fibrosis","volume":"78","year":"1998","unstructured":"Vic\n P, \n \n Ategbo\n S, \n \n Turck\n D, \n \n et al. Efficacy, tolerance, and pharmacokinetics of once daily tobramycin for pseudomonas exacerbations in cystic fibrosis. Arch Dis Child. 1998;78(6):536\u2013539."},{"issue":"2","key":"i1551-6776-21-3-239-b16","series-title":"Eur Respir J","first-page":"303","article-title":"Once-daily tobramycin in the treatment of adult patients with cystic fibrosis","volume":"19","year":"2002","unstructured":"Whitehead\n A, \n \n Conway\n SP, \n \n Etherington\n C, \n \n et al. Once-daily tobramycin in the treatment of adult patients with cystic fibrosis. Eur Respir J. 2002;19(2):303\u2013309."},{"issue":"5","key":"i1551-6776-21-3-239-b17","series-title":"Pediatr Pulmonol","first-page":"367","article-title":"Efficacy of once-daily tobramycin monotherapy for acute pulmonary exacerbations of cystic fibrosis: a preliminary study","volume":"31","year":"2001","unstructured":"Master\n V, \n \n Roberts\n GW, \n \n Coulthard\n KP, \n \n et al. Efficacy of once-daily tobramycin monotherapy for acute pulmonary exacerbations of cystic fibrosis: a preliminary study. Pediatr Pulmonol. 2001;31(5):367\u2013376."},{"issue":"5","key":"i1551-6776-21-3-239-b18","series-title":"Infection","first-page":"424","article-title":"Tobramycin once- vs thrice-daily for elective intravenous antipseudomonal therapy in pediatric cystic fibrosis patients","volume":"37","year":"2009","unstructured":"Riethmueller\n J, \n \n Ballmann\n M, \n \n Schroeter\n TW, \n \n et al; German Multicenter Study Group. Tobramycin once- vs thrice-daily for elective intravenous antipseudomonal therapy in pediatric cystic fibrosis patients. 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Optimization of anti-pseudomonal antibiotics for cystic fibrosis pulmonary exacerbations: V: aminoglycosides. Pediatr Pulmonol. 2013;48(11):1047\u20131061."},{"issue":"4","key":"i1551-6776-21-3-239-b21","series-title":"J Antimicrob Chemother","first-page":"553","article-title":"Distribution and elimination of tobramycin administered in single or multiple daily doses in adult patients with cystic fibrosis","volume":"50","year":"2002","unstructured":"Aminimanizani\n A, \n \n Beringer\n PM, \n \n Kang\n J, \n \n et al. Distribution and elimination of tobramycin administered in single or multiple daily doses in adult patients with cystic fibrosis. J Antimicrob Chemother. 2002;50(4):553\u2013559."},{"issue":"2","key":"i1551-6776-21-3-239-b22","series-title":"Diagn Microbiol Infect Dis","first-page":"123","article-title":"Pharmacodynamics of tobramycin in patients with cystic fibrosis","volume":"52","year":"2005","unstructured":"Mouton\n JW, \n \n Jacobs\n N, \n \n Tiddens\n H, \n \n Horrevorts\n AM.\n \n \n Pharmacodynamics of tobramycin in patients with cystic fibrosis. Diagn Microbiol Infect Dis. 2005;52(2):123\u2013127."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/21\/3\/article-p239.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/21\/3\/239\/1782236\/1551-6776-21_3_239.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/21\/3\/article-p239.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/21\/3\/article-p239.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:41:21Z","timestamp":1747356081000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/21\/3\/article-p239.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":22,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-21.3.239","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2016]]}}}