Combined topical pulmonary and systemic gentamicin: The question of safety.

Serum levels were measured in 13 subjects who received gentamicin either by inspiratory intermittent positive pressure breathing (IPPB-I) or by tracheal instillation. Only in the latter group were significant serum levels achieved. It is recommended that systemic doses of gentamicin should be reduced and serum levels closely monitored in order to avoid toxicity when the usual 3 to 5 mg/kg of IM or IV gentamicin is conbined with tracheal instillation.