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Use of Inhaled Tobramycin in Cystic Fibrosis

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Abstract

Chronic infection with Pseudomonas aeruginosa is associated with poor outcomes in patients with cystic fibrosis (CF). It leads to a reduced quality of life, acceleration of the decline in lung function, and increased frequency and severity of pulmonary exacerbations. Tobramycin, administered by inhalation as a long-term therapy, decreases bacterial density in airways, reduces exacerbation frequency, and improves quality of life and lung function in patients with chronic P. aeruginosa infection. In the last decade, tobramycin inhalation has become an important contributor to CF treatment as a means to control chronic infection and as a first-line treatment for the eradication of early acquisition of P. aeruginosa. Recently, a dry powder inhalation (DPI) form of tobramycin has become available, which is more convenient for administration and has comparable efficacy to the tobramycin solution. This DPI, the Podhaler™ (Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA), requires less time for treatment delivery and is more portable than a nebulizer, and so is a welcome additional therapeutic option for many patients.

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Acknowledgments

No funding or sponsorship was received for this study or publication of this article. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on the article. Changes resulting from comments received were made by the author based on their scientific and editorial merit. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.

Conflict of interest

Michal Shteinberg was a visiting research fellow at Queen’s University Belfast with financial support from Novartis Pharmaceuticals. J. Stuart Elborn has undertaken consultancy work for Novartis; all payments were made to Queens University Belfast.

Compliance with ethics guidelines

This review is based on previously conducted studies, and does not involve any new studies of human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Pulmonology and CF Center, Carmel Medical Center, and the Rappaport Faculty of Medicine, Haifa, Israel

    Michal Shteinberg

  2. Center for Infection and Immunity, Queen’s University of Belfast, Belfast, UK

    Michal Shteinberg & J. Stuart Elborn

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  1. Michal Shteinberg
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  2. J. Stuart Elborn
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Correspondence to Michal Shteinberg.

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Shteinberg, M., Elborn, J.S. Use of Inhaled Tobramycin in Cystic Fibrosis. Adv Ther 32, 1–9 (2015). https://doi.org/10.1007/s12325-015-0179-3

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