Tobramycin solution for inhalation in cystic fibrosis patients: a review of the literature
March 2007, Vol. 8, No. 4
,
Pages 467-475
(doi:10.1517/14656566.8.4.467)
Jennifer K Hagerman†1, Stephanie A Knechtel2 & Michael E Klepser3
1Assistant Professor of Pharmacy, Ferris State University, Hurley Medical Center, One Hurley Plaza, Pharmacy Department, Flint, MI 48503, USA. JenniferHagerman@ferris.edu
2Ferris State University, 1000 Oliver Street, Spindler Hall, Kalamazoo, MI, USA. knec2@fsuimail.ferris.edu
3Professor of Pharmacy, Ferris State University, Borgess Medical Center, 1000 Oliver Street, Spindler Hall, Kalamazoo, MI, USA. MichaelKlepser@ferris.edu
Cystic fibrosis patients suffer increased sputum production and a notable decline in respiratory function throughout the progression of their disease. Patients are left vulnerable to respiratory colonization/infection from a number of pathogens, including Pseudomonas aeruginosa. At present, the only antibiotic formulation that is FDA approved for aerosolized delivery is tobramycin solution for inhalation (TSI). TSI allows for targeted antibiotic delivery to the lungs and is indicated for maintenance therapy in cystic fibrosis patients infected with P. aeruginosa. Studies demonstrate that cyclical treatment with TSI is associated with an increase in respiratory function and a decrease in sputum density in cystic fibrosis patients. Additional benefits include fewer hospitalizations and a decreased need for systemic antibiotics. However, because of the need for chronic administration, issues such as emergence of resistant organisms and toxicity are a potential concern and have also been evaluated. This review details the pharmacology of TSI and literature involving its use in cystic fibrosis patients.
