Homogeneous Immunoassays—Therapeutic Drug Monitoring
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INNOFLUOR® Tobramycin Assay System
The INNOFLUOR® TOBRAMYCIN Assay System is intended for the quantitative determination of total tobramycin in serum for therapeutic drug monitoring by fluorescence polarization immunoassay (FPIA). The assay system is for use on the TDx® or the TDxFlxTM (TDx®/TDxFLx®) analyzer.
Tobramycin is an aminoglycoside antibiotic, with properties similar to gentamicin, which is used to treat resistant and serious infections due to gram negative bacteria.1-4 Tobramycin is particularly effective against Pseudomonas aeruginosa infections and is used to treat pneumonia and bacteremia caused by this organism.1-2 The aminoglycosides appear to inhibit bacterial protein synthesis by specifically binding to the 30 S ribosomal subunit.3-5
Tobramycin is routinely administered intravenously or intramuscularly, is reapidly dispersed into extracellular fluid, does not cross most cell membranes, and is essentially unbound to serum proteins.3 As with other aminoglycosides, tobramycin is potentially ototoxic and nephrotoxic.1-10 In patients with normal renal function, tobramycin is rapidly excreted, primarily by glomerular filtration, with an elimination half-life of approximately three hours.3,10,11 The use of tobramycin in renal patients must be carefully monitored. Measurement of serum levels is necessary to prevent toxicity and inadequate dosing, due to wide individual variation in the elimination and distribution of tobramycin.3,4 Immunoassays using a fluorescence polarization technique for tobramycin have been published.12,13
Duncan IB, Penner JL. Comparative activity of tobramycin and gentamicin against pseudomonas, proteus, and providencia species. Can Med Assoc J 1975; 113: 29-31.
Brogden RN, Pinder RM, Sawyer PR, et al. Tobramycin: a review of its antibacterial and pharmacokinetic properties and therapeutic use. Drugs 1976; 12: 166-200.
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Edson RS, Terrell CL. The aminoglycosides. Mayo Clin Proc 1991; 66(11): 1158-1164.
Anhalt JP. Interpretation of antimicrobial concentrations in serum. AACC Therapeutic drug monitoring continuing education and Q.C. program, April 1981: 1-11.
Slaughter RL. Probability assessment approach to therapeutic drug monitoring: tobramycin. DICP 1989; 23:240-244.
Aarons L, Bozeh S, Wenk M, Weiss Ph, Follath F. Population pharmacokinetics of tobramycin. Br J Clin Pharmac 1989; 28: 305-314.
Hahlmeter G, Hallberg T, Kamme C. Gentamicin and tobramycin in patients with barious infections- nephrotoxicity. Antimicrob Chemother 1978; 4: 47-52.
Wells JS, Emmercon JL, Gibson R, et al. Preclinical toxicology studies with tobramycin. Toxicol Appl Pharmaco. 1973; 25: 398-409.
Israel KS, Welles JS, Black HR. Pharmacology and toxicity. Aspects of pharmacology and toxicology of tobramycin in animals and humans. J Infec Dis 1976; 134: s97-103.
Naber KG, Westenfelder SR, Madsen PO. Pharmacokinetics of the aminoglycoside antibiotic tobramycin in humans. Antimicrob Agents Chemother 1973; 3: 469-473.
Jolley ME, Stroupe SD, Wang CJ, et al. Fluorescence polarization immunoassay1. Monitoring aminoglycoside antibiotics in serum and plasma. Clin Chem 1981; 27: 1190-1197.
Joos B, Luthy R, Blaser J. Long term accuracy of fluorescence polarization immunoassays for gentamicin, tobramycin, netilmicin, and vancomycin. Journal of Antimicrobial Chemotherapy 1989; 24: 797-803.
