Home

Personnel

Publications

Newsletters

Glossary

Bibliography

Calendar

Services

Products

Instructions,
Descriptions,
Manuals

Links

Aerosolized Antibiotic Therapy

Reference:  Use of Aerosolized Antibiotics in Patients with Cystic Fibrosis:  Tobramycin Solution for Inhalation.  Richard B. Moss, MD.  ATS 2000 Conference - Symposia Excerpts.  22-23.

The long term effects of Tobramycin Solution for Inhalation (TSI) are currently being observed.  TSI is commonly used in patients with cystic fibrosis (CF).  CF is a genetic disease involving disordered water and salt transport in the lungs.  This results in chronic bacterial bronchitis with bronchiectasis. Survival time decreases mainly due to infection with P aeruginosa.  Aggressive intravenous treatment with antibiotics increases survival time in CF patients with P aeruginosa.  Although it is effective in all CF patients, TSI is now known to be well tolerated and especially effective in increasing lung function in adolescents.

Tobramycin is an aminoglycoside antibiotic commonly used in CF patients.  The usual treatment protocol is 300 mg inhaled daily for 28 days followed by 28 days off.  The time off is to decrease probability of developing bacterial resistance.  The dose of 300 mg bid yields 25 times the minimum inhibitory concentrations (MIC) in sputum of 90% of isolates from CF patients.  The only adverse effects observed are voice alteration and tinnitus.  These resolved with continued exposure.  Intravenous Tobramycin is often associated with nephrotoxicity and ototoxicity.  Other side effects observed were fever, abdominal pain, vomiting and anorexia.  When patients treated with TSI for 2 years were compared to a group treated with placebo, the TSI treated patients were less likely to be hospitalized.  They also required fewer oral and intravenous antibiotics.