Evidence of Inhaled Tobramycin in Non-Cystic Fibrosis Bronchiectasis



Montserrat Vendrell*, 1, 2, Gerard Muñoz 1, Javier de Gracia 2, 3
1 Bronchiectasis Group. [Girona Biomedical Research Institute] IDIBGI, Dr Trueta University Hospital, Girona, Spain
2 CIBER de Enfermedades Respiratorias (Ciberes CB06/06/0030), Instituto de Salud Carlos III, Spain
3 Department of Pulmonology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona


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© Vendrell et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Bronchiectasis Group. IDIBGI, Dr Trueta University Hospital, Girona, Avd França s/n (9º planta), 17007 Girona, Spain; Tel: +34 972940294; Fax: +34 972940220; E-mail: mvendrell.girona.ics@gencat.cat


Abstract

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.

Keywords: Bronchiectasis, inhaled, tobramycin.