Tobramycin Ceftazidime

The final component of the dialysis prescription that may affect drug clearance by dialysis is whether or not the patient has anthorized the unit to reuse his or her dialyzer. Currently, more than 75% of all dialysis units in the United States use this procedure to reduce the cost of chronic hemodialysis. The effect of dialysis filter reuse on the clearance of endogenous molecules such as urea, creatinine, and P2-microglobulin has been evaluated for many dialyzers. A decrease in urea and creatinine clearances and an increase in /S2-mictoglobulin clearance was observed with some, but not all, dialyzers. Only one center has evaluated the effect of reuse on drug clearance (cefazolin, ceftazidime, tobramycin, and vancomycin) following the first and tenth use of cellulose acetate, cellulose triacetate, and polysulfone... 

Gram-negative rods Tobramycin 3-14 mg/mL or Gentamicin 3-14 mg/mL or Ceftazidime SO mg/mL or Fluoroquinolones 3 mg/mL Less severe keratitis may use less frequent dosing Antibiotics may be alternated each hour for ulcers and contact lens... 

Empirical therapy for postoperative infections in neurosurgical patients (including patients with CSF shunts) should include vancomycin in combination with either cefepime, ceftazidime, or meropenem. Linezolid has been reported to reach adequate CSF concentrations and resolve cases of meningitis refractory to vancomycin.35 However, data with linezolid are limited. The addition of rifampin should be considered for treatment of shunt infections. When culture and sensitivity data are available, pathogen-directed antibiotic therapy should be administered. Removal of infected devices is desirable aggressive antibiotic therapy (including high-dose intravenous antibiotic therapy plus intraventricular vancomycin and/or tobramycin) may be effective for patients in whom hardware removal is not possible.36... 

Dual therapy with Cefepime, ceftazidime, imipenem, meropenem, Gentamicin or tobramycin 2 mg/kg loading dose... 

Optimal antibiotic therapies for gram-negative bacillary meningitis have not been fully defined. Meningitis caused by Pseudomonas aeruginosa is initially treated with ceftazidime or cefepime, piperacillin + tazobactam, or meropenem plus an aminoglycoside, usually tobramycin. 

Van t Veen A, Mouton JW, Gommers D, Kluytmans JAJ, Dekkers P, Lachmann B (1995) Influence of pulmonary surfactant on in vitro bactericidal activities of amoxicillin, ceftazidime, and tobramycin. Antimicrob Agents Chemother 39 329-333. 

When catheter-related septicemia is suspected or proven vancomycin ((2-3) x I g) is started while vancomycin trough levels are monitored. Removal of the catheter must be considered with persistent fever or when blood cultures remain positive under effective vancomycin trough levels (10-15 mg/1). In a rapidly progressive infection (pneumonia) in a neutropenic patient anti-pseudomonas duo-therapy, e.g. ceftazidime with tobramycin, should be considered. 

Answer The patient s high serum creatinine indicates compromised renal function. The aminoglycosides can be nephrotoxic and thus the drug was not employed. However, tobramycin might have been used together with ceftazidime if the dose were adjusted for renal function. 

Joshi M, Bernstein J, Solomkin J, Wester BA, Kuye O. Piperacillin/tazobactam plus tobramycin versus ceftazidime plus tobramycin for the treatment of patients with nosocomial lower respiratory tract infection. Piperacillin/ Tazobactam Nosocomial Pneumonia Study Group. J Antimicrob Chemother 1999 43(3) 389-97. 

Intravenous drug abusers Pseudomonas Ciprofloxacin 750 mg PO twice daily or ceftazidime 2 g IV every 8 hours plus tobramycin 5 mg/kg/ day IV... 

Empirical regimens containing vancomycin (ceftazidime 1-2 g every 8 h + vancomycin 0.5-1 g every 6-12 h) gentamicin or tobramycin ... 

Neutropenic patients—For suspected bacteremia in neutropenic patients, ceftazidime, imipenem, meropenem, or cefepime, each alone or in more seriously ill patients with an aminoglycoside (gentamicin, tobramycin or amikacin), would be a reasonable first choice. 

A fluoroquinolone a tetracycline gentamicin A fluoroquinolone amikacin a tetracycline trimethoprim-sulfamethoxazole cefotaxime, ceftizoxime, ceftriaxone, cefepime, or ceftazidime Gentamicin, tobramycin or amikacin trimethoprim-sulfamethoxazole ciprofloxacin, ticarcillin, mezlocillin, or piperacillin aztreonam cefotaxime ceftizoxime ceftriaxone cefepime or ceftazidime Ampicillin gentamicin, tobramycin, or amikacin carbenicillin, ticarcillin, mezlocillin, or piperacillin gentamicin, tobramycin, or amikacin amoxicillin/clavulanic acid ticarcillin/clavulanic acid piperacillin/tazobactam ampicillin/sulbactam trimethoprim-sulfamethoxazole imipenem or meropenem aztreonam a fluoroquinolone another cephalosporin... 

An aminoglycoside ciprofloxacin trimethoprim-sulfamethoxazole ticarcillin, mezlocillin, or piperacillin ceftazidime minocycline doxycycline sulbactam polymyxin Gentamicin or tobramycin imipenem a fluoroquinolone Doxycycline azithromycin... 

Ceftazidime, imipenem, meropenem, aztreonam, cefepime -i- tobramycin, gentamicin, or amikacin ciprofloxacin... 

Noninterfering acetaminophen, amikacin, ceftazidime, ceftriaxone, genteimicin, nafcillin, phenytoin, ticarcillin, tobramycin, vancomycin... 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, ampicil-lin, carbamazepine, cefamandole, cefazolin, cefoperazone, cefotaxime, cefoxitin, ceftazidime, ceftizoxime, cephalexin, cephalothin, cephapirin, chloramphenicol, ciprofloxacin, clonazepam, (yclosporine, desipramine, digoxin, disopyramide, ethosuximide, gentamicin, haloperidol, imipramine, kanamycin, lidocaine, mezlocillin, netilmicin, nortriptyline, phenobarbital, phenytoin, primidone, procainamide, propranolol, quinidine, salicylic acid, streptomycin, sulfamethoxazole, theophylline, thiamphenicol, ticarcillin, tobramycin, trimethoprim, vancomycin... 

Noninterfering acetaminophen, acyclovir, allopurinol, amoxicillin, amphotericin B, am-picillin, aspirin, azlocillin, bendrofluazide, bumetanide, buprenorphine, carbenidllin, cefazolin, cefotaxime, cefoxitin, ceftazidime, cefuroxime, cephalexin, chlorambucil, chloramphenicol, chlordiazepoxide, chlorpheniramine, chlorpropamide, cyclophosphamide, cyclosporin, C5d arabine, daunorubicin, dextropropoxyphene, dihydrocodeine, domperidone, flucytosine, furosemide, gentamicin, griseofulvin, melphalan, methotrexate, metochlo-pramide, metronidazole, miconazole, nabilone, netilmicin, nicotinamide, nitrazepam, penicillin G, piperacillin, prednisolone, procarbeizine, prochlorperazine, riboflavin, rifampin, sulfamethoxazole, thioguanine, tobramycin, tolbutamide, trimethoprim... 

Another study assessing the risk factors for nephrotoxicity with aminoglycosides (tobramycin and gentamicin) enrolled 1489 patients, 157 of whom developed clinical nephrotoxicity. Of these patients 118 had no immediately identifiable cause (such as acute renal failure) and further evaluation of other risk factors found that the concurrent use of cephalosporins (including cefazolin, cefotaxime, cefoxitin, cefamandole, ce-furoxime, ceftriaxone, and ceftazidime) significantly increased the risk of nephrotoxicity. ... 

Aronoff GR, Brier RA, Sloan RS, Brier ME, Interactions of ceftazidime and tobramycin in patients with normal and impaired renal function, Antimicrob Agents Chemother (1990) 34, 1139-42,... 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, amlodi-pine, carbamazepine, cefotaxime, ceftazidime, chloramphenicoL ciprofloxacin, cisapride, clindamycin, clonidine, codeine, cyclosporine, digoxin, diphenhydramine, disopyramide, ethosuximide, fluconazole, gentamicin, gentamicin, heparin, labetalol, levothyroxine, li-docaine, lithium, methotrexate, metronidazole, minoxidil, nafdllin, nifedipine, phenobar-bital, phenobarbital, phenytoin, phenytoin, primidone, procainamide, propranolol, quini-dine, ranitidine, salicylic acid, theophylline, tobramycin, tobramycin, valproic acid, warfarin... 

Noninterfering aztreonam, ceftazidime, ciprofloxacin, meropenem, piperacillin, ticar-cillin, tobramycin... 

Abbreviations. Antibiotics A = amphotericin B CZA = ceftazidime G = gentamicin N = norfloxacin Nal = nalidixic acid Neo Nys = nystatin O = ofloxacin P = polymixin T = tobramycin CFX = cefotaxime O = ofloxacin Trim = trimethoprim. Surveillance Etr = endotracheal aspirate G = gastric aspirate O = oropharynx R = rectal swab U = urine W = wound swab. 

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