Tobramycin is a type of inhaled antibiotic prescribed for people with cystic fibrosis who develop a Pseudomonas aeruginosa infection. P. aeruginosa is a bacteria that can cause infections in the lungs of people with weakened immune systems, as is the case with CF patients. Tobramycin is commercialized as an inhalation solution under the brand names TOBI and Bethkis, or as inhalation dry powder under the brand name TOBI Podhaler.

The antibiotic is a sterile, clear, slightly yellow, non-pyrogenic, aqueous solution with the pH and salinity adjusted for administration by a compressed air, reusable nebulizer. According to the Cystic Fibrosis Foundation (CFF), antibiotics are an important part of the treatment plan for CF patients, due to the high prevalence of respiratory infections from agents like P. aeruginosa.

History of Tobramycin

Tobramycin, an aminoglycoside,  broad-spectrum antibiotic, produced by Streptomyces tenebrarius, is widely used against gram-negative bacterial infections, and is reported in published studies to be particularly useful for the treatment of P. aeruginosa in CF patients.

Trobramycin was first approved to treat these infection in 1997 under the brand name TOBI by Novartis, and in 2002 as Bethkis by Chiesi USA.

How Tobramycin Works

“Aerosolized tobramycin has been extensively used in cystic fibrosis (CF) patients in order to directly deliver the antibiotic to the endobronchial site of infection, and decrease toxicity by limiting systemic absorption. Aerosolized tobramycin doses ranging from 80 mg twice or three times daily to 600 mg three times daily have been used in various clinical trials. At an 80-mg dose, preservation of pulmonary function with little or no improvement over the baseline was reported. Tobramycin, nebulized at 600 mg three times daily, significantly improved clinical and pulmonary functions and reduced the density of Pseudomonas aeruginosa in the sputum. No toxicity or nephrotoxicity was reported at either dose,” investigators reported in the clinical study “Efficacy and safety of aerosolized tobramycin in cystic fibrosis.”

Other Details about Tobramycin

This antibiotic is contraindicated in patients with a known hypersensitivity to any aminoglycoside. In addition, before starting a treatment with tobramycin, patients should consult their physicians. The most common side effects of its use  include cough, runny nose, a stuffy nose, discolored sputum, difficulty breathing and fever. Less common side effects include tarry stools, chest pain, chills, ringing or buzzing in the ears, hearing loss, painful or difficult urination, sore throat, swollen glands, unusual bleeding or bruising, and tiredness.

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