Tobramycin
Tobramycin
- Inhibits protein synthesis by irreversibly binding to the 30S bacterial ribosome
- Active against most Gram-negative bacilli
- Activity against
- BCC strains or S. maltophilia
- Enterococcus
- Staphylococcus
- Tobramycin Solution for Inhalation (TSI) is registered as TOBI® (300 mg/5 ml)
- In combination with a PARI LC PLUS™ reusable jet nebuliser
- Suitable compressor resulting in a flow rate of 4–6 l/min
- Present in Bramitob® (300 mg/4 ml)
- In combination with a PARI LC PLUS™ reusable jet nebuliser and the PARI TURBO BOY™ compressor.
- Uptake across the bacterial cell wall is energy-dependent
- Impaired in anaerobic environments
- Low oxygen partial pressure in CF sputum plugs may limit the efficacy of this drug
- Tobramycin is positively charged and thought to be bound in CF airways to the negatively charged DNA fibers and P. aeruginosa alginate
- Intermittent (28-day on/28-day off) treatment, using 300 mg of tobramycin twice daily
- Significantly improved lung function and reduced sputum P. aeruginosa density
- Compared with placebo in CF patients
- Increases in lung function of about 10% at week 20 were most marked in adolescent patients (aged 13–17 years)
- Maintained for up to 96 weeks in an open-label extension study
- Fewer TSI than placebo recipients required parenteral anti-pseudomonal agents or hospitalisation
- Aerosolized tobramycin safely eradicated P. aeruginosa in the majority of CF patients for up to three months
- P. aeruginosa eradication was associated with reduced neutrophilic airway inflammation.
- Inhibits protein synthesis by irreversibly binding to the 30S bacterial ribosome
- Active against most Gram-negative bacilli
- tobramycin-solution-for-inhalation">my.clevelandclinic.org/health/drugs/18505-tobramycin-solution-for-inhalation
