Would you recommend avoiding intravesical (bladder) tobramycin administration in a patient with advanced chronic kidney disease?

Guess fear is absorption, build up, and toxicity.

A single loading dose of an aminoglycoside is not to toxic level. Maintaining the level of risks ototoxicity, build up also nephrotoxicity.

Would depend on absorption and residual GFR.

Try a single loading dose, check levels after 12 or 24 hours to g...