The Use of Aerosolized Tobramycin in the Treatment of a Resistant Pseudomonal Pneumonitis

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Abstract
Aerosolized tobramycin was given to a 68-year-old man with resistant Pseudomonas aeruginosa pneumonitis at a dose of 100 mg every 8 h via a tracheostomy, after the patient failed to respond adequately to parenteral aminoglycoside and ticarcillin therapy. Minimum inhibitory concentration and minimum bactericidal concentration for tobramycin and gentamicin were 16 .mu.g/ml and > 16 .mu.g/ml, which necessitated aerosol administration. Tracheal concentrations 15 min and 4 h after a dose were 1,560 and 930 .mu.g/ml. The patient responded and eventually was discharged from the hospital. Thus, monotherapy with an aerosolized aminoglycoside may be effective in some patients wtih resistant Pseudomonas aeruginosa pneumonitis.

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