ArticlePediatric research2026
Pharmacokinetic analysis of conventional tobramycin dosing for infants in the cardiac intensive care unit.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
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Abstract
backgroundAminoglycoside pharmacokinetic data are limited in infants with congenital heart disease (CHD). This study aimed to characterize tobramycin pharmacokinetics and determine optimal intravenous dosing for infants in the cardiac intensive care unit (CICU).
methodsA population pharmacokinetic analysis was performed in infants >1 month to <12 months of age initiated on intravenous conventional dosing tobramycin in the CICU from January 1, 2020, through December 31, 2024. Simulations were performed to determine dosage regimens achieving the desired peak (8-12 mg/L) and trough (<1 mg/L) concentrations. Regimens were also evaluated in achieving secondary targets based on the area under the concentration-time curve (AUC).
resultsFifty-five infants, with a median age of 3.5 months and a weight of 5.1 kg, were included. Twenty (36.4%) patients were premature. A two-compartment model best described the pharmacokinetic data, with weight and eGFR identified as significant covariates for clearance. A 3.5 mg/kg/dose every-12-hour regimen optimally obtained target peak and trough concentration, and AUC targets. Infants with eGFRs <90 mL/min/1.73 m
conclusionTobramycin pharmacokinetics in CHD infants were comparable to published data on non-CHD infants. A 3.5 mg/kg/dose every-12-hour regimen was optimal, with dose adjustments needed for eGFR <90 mL/min/1.73 m IMPACT: Tobramycin pharmacokinetic data are limited in infants with congenital heart disease (CHD). A dosing regimen of 3.5 mg/kg/dose every 12 hours for intravenous tobramycin achieves therapeutic targets in infants aged 1 month to 1 year with CHD in the cardiac intensive care unit (CICU). Infants with estimated glomerular filtration rates <90 mL/min/1.73 m
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