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Are trough tobramycin concentrations taken from a central venous catheter accurate enough to safely use?
  1. Hannah Tumelty1,
  2. Geoff Shenton2,
  3. Malcolm Brodlie3,4
  1. 1 General Paediatrics, Great North Children's Hospital, Newcastle upon Tyne, UK
  2. 2 Paediatric Oncology and Haematology, Great North Children's Hospital, Newcastle upon Tyne, UK
  3. 3 Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
  4. 4 Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle Upon Tyne, UK
  1. Correspondence to Dr Hannah Tumelty, Great North Children's Hospital, Newcastle Upon Tyne NE1 4LP, UK; hannah.tumelty{at}nhs.net

http://dx.doi.org/10.1136/archdischild-2022-323836

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    Scenario

    A 15-year-old girl with cystic fibrosis (CF) and needle phobia has recently had a port-a-cath placed to facilitate regular intravenous antibiotic administration. She is admitted to the respiratory ward to receive ceftazidime and tobramycin to treat Pseudomonas aeruginosa. Local guidance requests a blood sample for trough tobramycin concentration to be taken peripherally prior to the second dose. This is due to concerns about the risk of falsely elevated concentrations if sampled from the same line used to give the drug. The patient is anxious and asks, “why can’t you just take it from my port like other blood tests?”

    In other departments, such as paediatric oncology, antibiotic concentrations are sampled from the same central line through which the drug is given, prompting us to question could we also spare our respiratory patients the trauma of a peripheral venepuncture to measure tobramycin trough concentrations?

    Structured clinical question

    In children …

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    Footnotes

    • Contributors HT contributed to the conception of the work and wrote the first draft of the paper. GS and MB contributed to the conception of the work and commented on the final draft of the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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