HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (11) Citing Articles via Google Scholar Google Scholar Articles by Nikolaizik, W.H. Articles by Ratjen, F. Search for Related Content PubMed PubMed Citation Articles by Nikolaizik, W.H. Articles by Ratjen, F.

Bronchial reactions to the inhalation of high-dose tobramycin in cystic fibrosis

Dept of Paediatrics, University Hospital Essen, Essen, Germany

CORRESPONDENCE: W.H. Nikolaizik, Dept of Paediatrics, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany. Fax: 49 2017235721. E-mail: wilfried.nikolaizik@uni-essen.de

Keywords: bronchial response, bronchodilator, cystic fibrosis, inhalation, lung function, tobramycin

Received: June 25, 2001
Accepted January 31, 2002

It has been established that inhaled tobramycin has a positive effect on respiratory function in Pseudomonas-aeruginosa positive patients with cystic fibrosis (CF). In a previous study the authors reported that low-dose tobramycin preparations containing the preservative phenol caused significant bronchial obstruction. Recently, high-dose tobramycin preparations with and without preservatives/phenol have become available.

To assess the airway response to these preparations flow/volume curves in 12 patients with CF (four males, eight females, mean age±sd=19.0±7.4 yrs) were measured. The tobramycin preparations: Nebicina® 2.0 mL (150 mg, containing the preservative phenol), Distobram® 3.0 mL (150 mg, containing preservatives), Tobi® 5.0 mL (300 mg), Tobi® 2.5 mL (150 mg), and Tobi® 5.0 mL, were used after bronchodilator application.

Immediately and/or 5 min after the tobramycin inhalations there was a significant fall in lung function with the different preparations. There was no significant difference between preparations with and without preservatives/phenol. The bronchial obstruction was comparable to that observed after the inhalation of low-dose tobramycin and after saline. After 10 min of inhalation, the lung function returned to baseline values. Most patients preferred the Tobi® 2.5 mL and disliked the Nebicina® preparation due to the unpleasant taste. Preceding treatment with bronchodilators prevented the decline in lung function.

Assessment of bronchial response at the first nebulisation of high-dose tobramycin and, in case of significant obstruction, ß-agonists in combination with the antibiotic inhalation are recommended.

This article has been cited by other articles:

				T. Art, B. de Moffarts, D. Bedoret, E. van Erck, and P. Lekeux Pulmonary function and antimicrobial concentration after marbofloxacin inhalation in horses Vet Rec., September 8, 2007; 161(10): 348 - 349. [Full Text] [PDF]

				P. A. Flume, C. Strange, X. Ye, M. Ebeling, T. Hulsey, and L. L. Clark Pneumothorax in Cystic Fibrosis Chest, August 1, 2005; 128(2): 720 - 728. [Abstract] [Full Text] [PDF]

				P. A. LoBue Inhaled Tobramycin: Not Just for Cystic Fibrosis Anymore? Chest, April 1, 2005; 127(4): 1098 - 1101. [Full Text] [PDF]

				S P Conway Nebulized antibiotic therapy: the evidence Chronic Respiratory Disease, January 1, 2005; 2(1): 35 - 41. [Abstract] [PDF]

				M. Griese, J. Ramakers, A. Krasselt, V. Starosta, S. van Koningsbruggen, R. Fischer, F. Ratjen, B. Mullinger, R. M. Huber, K. Maier, et al. Improvement of Alveolar Glutathione and Lung Function but Not Oxidative State in Cystic Fibrosis Am. J. Respir. Crit. Care Med., April 1, 2004; 169(7): 822 - 828. [Abstract] [Full Text] [PDF]