Evidence of Inhaled Tobramycin in Non-cystic Fibrosis Bronchiectasis
Overview
Affiliations
There is currently less experience with inhaled tobramycin in non-cystic fibrosis bronchiectasis than in cystic fibrosis (CF). Intravenous formulation and solution for inhalation (TSI) have been studied in non-CF bronchiectasis patients with chronic P. aeruginosa bronchial infection. An improvement in clinical parameters and a reduction in bacterial density have been shown with both inhaled solutions in these patients. However, further trials are needed to determine the most effective dose and administration protocol in these patients. Based on the current evidence, recommendations cannot be made regarding the use of TSI to treat exacerbations. Although no systemic toxicity has been reported in studies specifically investigating this treatment, patients with known kidney disease or ear disorders should be treated with caution. Adverse respiratory effects are reported to be more common in non-CF patients than in CF patients, who tend to be non-smokers and younger. Research is being conducted into the possibility of combining tobramycin with other antibiotics to increase its antibacterial activity. In this review we will present and discuss the published evidence regarding the use of inhaled tobramycin in non-CF bronchiectasis.
Debnath S, Debnath M, Srivastava R Heliyon. 2023; 8(12):e12620.
PMID: 36619445 PMC: 9816992. DOI: 10.1016/j.heliyon.2022.e12620.
Tobramycin Serum Concentrations in Tracheostomy-Dependent Children Receiving Inhaled Tobramycin.
Hughes K, Cristea A, Tillman E Pediatr Allergy Immunol Pulmonol. 2022; 33(2):92-95.
PMID: 35921575 PMC: 8443261. DOI: 10.1089/ped.2020.1161.
Al-Jahdali H, Alshimemeri A, Mobeireek A, Albanna A, Al Shirawi N, Wali S Ann Thorac Med. 2017; 12(3):135-161.
PMID: 28808486 PMC: 5541962. DOI: 10.4103/atm.ATM_171_17.
Inhaled Antibiotic Therapy in Chronic Respiratory Diseases.
Maselli D, Keyt H, Restrepo M Int J Mol Sci. 2017; 18(5).
PMID: 28509852 PMC: 5454974. DOI: 10.3390/ijms18051062.
Inhaled Antibiotics for Gram-Negative Respiratory Infections.
Wenzler E, Fraidenburg D, Scardina T, Danziger L Clin Microbiol Rev. 2016; 29(3):581-632.
PMID: 27226088 PMC: 4978611. DOI: 10.1128/CMR.00101-15.