Evidence map›Paper›PMID 40534942›Full record

ArticleThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG2025

Inhaled Tobramycin Usage in Critically Ill Pediatric Patients Without Cystic Fibrosis: A Pediatric Pharmacy-Association, Practice-Based Research Network Survey Study.

Peter N Johnson, Dominique L Ropp, Courtney Ranallo, Hala Chaaban, Lucila Garcia-Contreras, Stephen Neely, Jamie L Miller

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Article in The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Peter N JohnsonDepartment of Pharmacy (JLM, SBN, PNJ), Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Dominique L RoppDivision of Pharmacy (DR), Children's National Hospital, Washington, DC.
Courtney RanalloDepartment of Pediatrics (CR, HC), College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Hala ChaabanDepartment of Pediatrics (CR, HC), College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Lucila Garcia-ContrerasDepartment of Pharmaceutical Sciences (LGC), College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Stephen NeelyDepartment of Pharmacy (JLM, SBN, PNJ), Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Jamie L MillerDepartment of Pharmacy (JLM, SBN, PNJ), Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe purpose of this study was to characterize reported usage, dosage regimens, and monitoring practices of inhaled tobramycin in health systems with neonatal intensive care units (NICUs), pediatric intensive care units (PICUs), and cardiovascular intensive care units (CICUs) from the members of the Pediatric Pharmacy Association (PPA). The primary objective was to identify the number of respondents who use an inhaled tobramycin protocol. The secondary objectives included the main indications, dosage regimens, monitoring parameters used, and administration details for inhaled tobramycin.

methodsA cross-sectional questionnaire was distributed to PPA members from March 28-May 22, 2023. Descriptive statistics were employed.

resultsThe questionnaire was completed by respondents at 79 institutions; respondents at 61 institutions used inhaled tobramycin in PICUs (n = 45; 73.8%), NICUs (n = 36; 59.0%), and CICUs (n = 14; 23.0%). Most respondents (n = 73; 92.4%) in the 61 institutions that use inhaled tobramycin did not have an established protocol. The most common tobramycin product used was a tobramycin nebulization solution, and the most common indication was ventilator-associated tracheitis. Respondents noted the most common dosage regimen was 40 to 80 mg every 8 to 12 hours or 150 mg every 12 hours, regardless of patient age. Most respondents were unaware of the nebulizer used and the location of the nebulizer within the ventilator circuit. Additionally, the respondents noted that their intensive care units do not routinely check tobramycin serum concentrations.

conclusionMost respondents did not have a standardized inhaled tobramycin protocol. There are variations in the dosage regimen, administration, and monitoring practices in critically ill children receiving inhaled tobramycin. Pediatric clinical pharmacists should work with interprofessional teams, including respiratory therapists and providers, to standardize the use of inhaled antibiotics.

Indexed as

acute kidney injuryinhaled tobramycinmechanical ventilatornebulizerspediatricspharmacokinetics

Identifiers

PMID40534942
PMCPMC12172681

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