Abstract
BACKGROUND: Parenteral aminoglycoside antibiotics, when used to treat Pseudomonas aeruginosa infections in cystic fibrosis, present problems due to toxicity, rapid systemic clearance, and poor pulmonary penetration. Aerosolized aminoglycosides avoid these problems but may cause bronchospasm in this susceptible population. Use of the bronchodilator albuterol in combination with the aminoglycoside aerosol would be logical but would require two separate treatments due to lack of information on the compatibility of the two drugs. We therefore studied their compatibility. METHODS: Tobramycin 40 mg and albuterol 2.5 mg were mixed to a final volume of 3.5 mL with 0.9% sodium chloride and stored in glass at 4°C. Chemical compatibility was determined by high-performance liquid chromatography for albuterol and by fluorescence immunoassay for tobramycin. Stability was determined initially, at 24 and 48 hr, and at 7 days after mixing. RESULTS: The concentrations of the two drugs remained relatively constant over the 7-day study period. CONCLUSIONS: Under the conditions studied, tobramycin and albuterol are chemically compatible for at least 7 days if refrigerated. This can ease preparation, increase patient treatment compliance at home, and reduce treatment time in the hospital when patients receive both medications.
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