Conclusions
The results of this study indicate that utilization of
AUC24, in combination with Cmax, may be
beneficial when monitoring IV tobramycin in patients with CF admitted
for an APE. The lack of correlation between increasing
AUC24 or Cmax and subsequent development
of AKI, in combination with the correlation of clinical efficacy and
AUC24 ≥80 mg*hr/L, suggest benefit in targeting an
AUC24 ≥80 mg*hr/L with minimal risk of additive
toxicity. Overall, given the significant correlation between
AUC24 and Cmax found within both
cohorts, AUC24 may be utilized, in combination with
Cmax, to enhance efficacy of IV tobramycin therapy in CF
patients being treated for an acute pulmonary exacerbation.
Additionally, given the significant increase in incidence of AKI with
multi-daily dosing of tobramycin, in combination with the lack of
correlation between time undetectable and efficacy or toxicity found
within this study, utilization of once-daily dosing of IV tobramycin
should be encouraged in both pediatric and adult patients with CF.