Efficacy of Aerosolized Tobramycin in Patients with Cystic Fibrosis

• Published in: The New England journal of medicine Vol. 328; no. 24; pp. 1740 - 1746
• Main Authors: Ramsey, Bonnie W, Dorkin, Henry L, Eisenberg, Jay D, Gibson, Ronald L, Harwood, Ivan R, Kravitz, Richard M, Schidlow, Daniel V, Wilmott, Robert W, Astley, Susan J, McBurnie, Mary Ann, Wentz, Kim, Smith, Arnold L
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 17-06-1993
• Subjects: Adolescent; Aerosols; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Bronchitis - drug therapy; Bronchitis - microbiology; Bronchitis - physiopathology; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - physiopathology; Double-Blind Method; Drug dosages; Female; Humans; Infections; Lungs; Male; Medical sciences; Monitoring, Physiologic; Mortality; Pharmacology. Drug treatments; Pseudomonas aeruginosa; Pseudomonas Infections - drug therapy; Pseudomonas Infections - physiopathology; Respiratory Mechanics; Tobramycin - administration & dosage; Tobramycin - therapeutic use; Pseudomonadales; Human; Respiratory disease; Treatment efficiency; Infection; Antibiotic; Chemotherapy; Mucoviscidosis; Treatment; Aerosols; Bacteria; Pseudomonadaceae; Pseudomonas aeruginosa
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199306173282403

Endobronchial infections with Pseudomonas aeruginosa, which contribute to progressive obstructive airway disease, are a major cause of morbidity and mortality among patients with cystic fibrosis
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. Aminoglycosides active against P. aeruginosa penetrate endobronchial secretions (sputum) poorly, necessitating large intravenous doses to attain an efficacious concentration at the site of infection. These high doses place the patient at risk for nephrotoxic
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and ototoxic
3
effects. The direct delivery of aminoglycosides to the lower airway by aerosol administration is attractive, since it produces high concentrations of antibiotic at the site of infection. In view of the limited absorption into the circulation, aerosol delivery . . .