Inhaled Tobramycin for Cystic Fibrosis

Chronic Pseudomonas aeruginosa infection contributes to ongoing pulmonary disease in cystic fibrosis (CF). Although aminoglycosides have excellent activity against P. aeruginosa, their systemic use in treating CF has been limited by toxicity and poor pulmonary penetration. Two separate multicenter, controlled trials now indicate that tobramycin administered by jet nebulizer can improve pulmonary function with minimal toxicity.

Five hundred and twenty patients with CF were randomized to receive 300 mg of inhaled tobramycin twice daily, for three cycles of 28 days on and 28 days off antibiotic therapy. Patients receiving tobramycin had a rapid and sustained increase in FEV₁ of approximately 10% at 20 weeks, compared with a 2% decline in the co…