{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:08:06Z","timestamp":1761156486066,"version":"3.44.0"},"reference-count":16,"publisher":"The Pediatric Pharmacy Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>\n          <jats:bold>OBJECTIVES<\/jats:bold> The primary objective of this study was to assess the nephrotoxicity and ototoxicity risks of extended interval tobramycin in cystic fibrosis (CF) patients who are &lt;6 years old. A secondary objective included analyzing pharmacokinetic parameters in this age group.<\/jats:p>\n        <jats:p>\n          <jats:bold>METHODS<\/jats:bold> A retrospective chart review was conducted of patients with CF who were &lt;6 years old, admitted for an acute pulmonary exacerbation from January 1, 2003, to January 1, 2014, and treated with intravenous tobramycin.<\/jats:p>\n        <jats:p>\n          <jats:bold>RESULTS<\/jats:bold> The median baseline serum creatinine (SCr) was 0.26 mg\/dL among the 31 patients included in the study. Of the 20 patients who experienced increases in SCr, the absolute median increase was 0.065 mg\/dL (0.033\u20130.1 mg\/dL). Abnormal audiograms seen in 4 patients are attributable to middle ear effusion present on exam. The median dose of tobramycin was 11.7 mg\/kg (11.3\u201312 mg\/kg), the elimination constant was 0.4 hr<jats:sup>\u22121<\/jats:sup>(0.32\u20130.47 hr<jats:sup>\u22121<\/jats:sup>), half-life was 1.7 hr (1.5\u20132.1 hr), volume of distribution was 0.37 L\/kg (0.31\u20130.47 L\/kg), and median peaks and troughs fell within ranges of 20 to 30 mg\/L (20.9\u201332.7 mg\/L) and &lt;0.01 mg\/L, respectively.<\/jats:p>\n        <jats:p>\n          <jats:bold>CONCLUSIONS<\/jats:bold> Extended interval dosing tobramycin is safe in CF patients who are &lt;6 years old. There was no drug-related ototoxicity, and some nephrotoxicity was observed. When dosed at 12 mg\/kg, similar pharmacokinetics were seen among all age groups, and concentrations were within the desired range.<\/jats:p>","DOI":"10.5863\/1551-6776-23.2.152","type":"journal-article","created":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T15:12:53Z","timestamp":1524669173000},"page":"152-158","source":"Crossref","is-referenced-by-count":5,"title":["Safety of Extended Interval Tobramycin in Cystic Fibrosis Patients Less Than 6 Years Old"],"prefix":"10.5863","volume":"23","author":[{"given":"Alexandria","family":"Arends","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Pettit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"key":"i1551-6776-23-2-152-b1","unstructured":"Cystic Fibrosis Foundation. \n          Patient registry annual data report 2013. http:\/\/www.cff.org\/UploadedFiles\/research\/ClinicalResearch\/PatientRegistryReport\/2013_CFF_Patient_Registry_Annual_Data_Report.pdf. Accessed January 19, 2018.","article-title":"Patient registry annual data report 2013"},{"issue":"9","key":"i1551-6776-23-2-152-b2","series-title":"Am J Respir Crit Care Med","first-page":"802","article-title":"Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations","volume":"180","year":"2009","unstructured":"Flume\n              P\n            , MogayzelP, RobinsonK, \n          et al. Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations. Am J Respir Crit Care Med. 2009;180(9):802\u2013808."},{"key":"i1551-6776-23-2-152-b3","unstructured":"Cystic Fibrosis Foundation. \n          Patient registry annual data report 2014. https:\/\/www.cff.org\/2014_CFF_Annual_Data_Report_to_the_Center_Directors.pdf. Accessed June 2015.","article-title":"Patient registry annual data report 2014"},{"issue":"4","key":"i1551-6776-23-2-152-b4","series-title":"J Pediatr Pharmacol Ther","first-page":"262","article-title":"National survey of extended-interval aminoglycoside dosing in pediatric cystic fibrosis pulmonary exacerbations","volume":"16","year":"2011","unstructured":"Prescott\n              WA\n              Jr.\n            \n          \n          National survey of extended-interval aminoglycoside dosing in pediatric cystic fibrosis pulmonary exacerbations. J Pediatr Pharmacol Ther. 2011;16(4):262\u2013269."},{"issue":"1","key":"i1551-6776-23-2-152-b5","series-title":"Pharmacotherapy","first-page":"95","article-title":"Extended-interval once-daily dosing of aminoglycosides in adult and pediatric patients with cystic fibrosis","volume":"30","year":"2010","unstructured":"Prescott\n              W\n            , NagelJ.\n          Extended-interval once-daily dosing of aminoglycosides in adult and pediatric patients with cystic fibrosis. Pharmacotherapy. 2010;30(1):95\u2013108."},{"issue":"9459","key":"i1551-6776-23-2-152-b6","series-title":"Lancet","first-page":"573","article-title":"Once versus three-times daily regimens of tobramycin treatment for pulmonary exacerbations of cystic fibrosis\u2014the TOPIC Study: a randomized controlled trial","volume":"365","year":"2005","unstructured":"Smyth\n              A\n            , TanK, Hyman-TaylorP, \n          et al. 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J Am Soc Nephrol. 2009;20(3):672\u2013679."},{"issue":"10","key":"i1551-6776-23-2-152-b9","series-title":"Kidney Int","first-page":"1028","article-title":"Modified RIFLE criteria in critically ill children with acute kidney injury","volume":"71","year":"2007","unstructured":"Akcan-Arikan\n              A\n            , ZappitelliM, LoftisL, \n          et al. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int. 2007;71(10):1028\u20131035."},{"issue":"3","key":"i1551-6776-23-2-152-b10","series-title":"J Am Soc Nephrol","first-page":"629","article-title":"New equations to estimate GFR in children with CKD","volume":"20","year":"2009","unstructured":"Schwartz\n              GJ\n            , Mu\u00f1ozA, SchneiderMF, \n          et al. New equations to estimate GFR in children with CKD. 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Antimicrob Agents Chemother. 2006;50(7):2293\u20132299."},{"issue":"6","key":"i1551-6776-23-2-152-b12","series-title":"J Infect Dis","first-page":"1026","article-title":"High-frequency audiometric monitoring for early detection of aminoglycoside ototoxicity","volume":"165","year":"1992","unstructured":"Fausti\n              SA\n            , HenryJA, SchafferHI, \n          et al. High-frequency audiometric monitoring for early detection of aminoglycoside ototoxicity. J Infect Dis. 1992;165(6):1026\u20131032."},{"issue":"2","key":"i1551-6776-23-2-152-b13","series-title":"Nat Clin Pract Nephrol","first-page":"80","article-title":"Drug-associated renal dysfunction and injury","volume":"2","year":"2006","unstructured":"Choudhury\n              D\n            , AhmedZ.\n          Drug-associated renal dysfunction and injury. 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