In Vivo Inactivation of Tobramycin by Ticarcillin

Inactivation of tobramycin sulfate by ticarcillin disodium was observed in a patient with impaired renal function. Tobramycin elimination half-life was seven hours with concurrent ticarcillin therapy but 35 hours without ticarcillin therapy. The magnitude of change cannot be attributed to changing renal function or tobramycin accumulation. The present case demonstrates that in vivo inactivation of tobramycin by ticarcillin can substantially increase the overall tobramycin elimination rate in patients with severe renal failure; however, in patients with normal renal function such inactivation is predicted to cause little change in overall tobramycin elimination rate. ( JAMA 1982;247:658-659)