RT Book, Section
A1 Beauduy, Camille E.
A1 Winston, Lisa G.
A2 Katzung, Bertram G.
SR Print(0)
ID 1148440182
T1 Aminoglycosides & Spectinomycin
T2 Basic & Clinical Pharmacology, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259641152
LK accessmedicine.mhmedical.com/content.aspx?aid=1148440182
RD 2024/04/24
AB CASE  STUDYA  45-year-old  man  with  no  significant  medical  history  was  admitted  to  the  intensive  care  unit  (ICU)  10  days  ago  after  suffering  third-degree  burns  over  40%  of  his  body.  He  had  been  relatively  stable  until  the  last  24  hours.  Now,  he  is  febrile  (39.5°C  [103.1°F]),  and  his  white  blood  cell  count  has  risen  from  8500  to  20,000/mm3.  He  has  also  had  an  episode  of  hypotension  (86/50  mmHg)  that  responded  to  a  fluid  bolus.  Blood  cultures  were  obtained  at  the  time  of  his  fever  and  results  are  pending.  The  ICU  attending  physician  is  concerned  about  a  bloodstream  infection  and  decides  to  treat  with  empiric  combination  therapy  directed  against  Pseudomonas  aeruginosa.  The  combination  therapy  includes  tobramycin.  The  patient  weighs  70  kg  (154  lb)  and  has  an  estimated  creatinine  clearance  of  90  mL/min.  How  should  tobramycin  be  dosed  using  once-daily  and  conventional  dosing  strategies?  How  should  each  regimen  be  monitored  for  efficacy  and  toxicity?