Abstract
Pseudomonas aeruginosa is a common respiratory pathogen found in patients with cystic fibrosis (CF), contributing
to increased hospitalization, more rapid progression of CF lung disease, and increased
risk of death. Guidelines recommend early therapy using tobramycin inhaled solution
(TIS) or inhaled powder (TIP). Both TIS and TIP treatment regimens have demonstrated
positive clinical outcomes in efficacy and safety, including improvements in FEV1, decreased sputum P. aeruginosa density, decreased rates in antipseudomonal antibiotic use, and reduced rates of
hospitalizations due to respiratory events. In a comparison of patient preference
for TIS versus TIP, a patient survey cited time savings and convenience as preferences
for TIP. However, both TIP and TIS offer advantages that may benefit patients and
increase treatment adherence depending on patient circumstances. TIS may be suitable
for younger patients at home where parents and caregivers may better control proper
administration, older individuals, and those with low FEV1. Dry powder inhalers are suitable when patients have less time to commit to their
self-care (eg, patients who work, are remotely located, return home late, or are on
vacation), and can reduce the patient treatment burden compared with nebulized delivery.
In this expert review, we summarize the available data on tobramycin regarding its
molecular characteristics, mechanism of action, and efficacy and safety for the treatment
of acute and chronic P. aeruginosa infection.
Keywords
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Article info
Publication history
Published online: February 25, 2022
Accepted:
February 17,
2022
Received in revised form:
February 16,
2022
Received:
November 5,
2021
Identification
Copyright
© 2022 Published by Elsevier Ltd.
