PMID- 28647460 OWN - NLM STAT- MEDLINE DCOM- 20180713 LR - 20180713 IS - 1879-1409 (Electronic) IS - 0305-4179 (Linking) VI - 43 IP - 8 DP - 2017 Dec TI - A prospective study evaluating tobramycin pharmacokinetics and optimal once daily dosing in burn patients. PG - 1766-1774 LID - S0305-4179(17)30301-7 [pii] LID - 10.1016/j.burns.2017.05.009 [doi] AB - BACKGROUND: Once-daily aminoglycoside dosing (ODA) is used in most patient populations to optimize antibacterial activity and reduce toxicity. Unfortunately, burn patients are excluded from ODA due to concerns over altered pharmacokinetics resulting in a shortened half-life and low peak aminoglycoside concentrations. Retrospective studies suggest that ODA may be appropriate if higher milligram/kilogram doses are used. However, no prospective clinical trials in burn patients exist to confirm these findings. OBJECTIVE: To determine the adequacy of once daily tobramycin dosed at 10mg/kg in adult burn patients. METHODS: This prospective single dose pharmacokinetic clinical trial was conducted at the Ross Tilley Burn Centre. Patients with a total burn surface area (TBSA) of <20% and creatinine clearance >/=50mL/min were eligible. A first-order one compartment model was used to determine the pharmacokinetic profile from 3 or 5 tobramycin levels over a 24h period per patient. Monte Carlo simulation (MCS) was performed to determine the probability of target level attainment. RESULTS: The mean percent TBSA, partial, and full thickness burn were 10%, 6%, and 4%, respectively. Nine of the ten patients recruited achieved peak concentrations of >/=20mg/L (mean of 29.4+/-5.7mg/L) and all patients had a trough level