PT - JOURNAL ARTICLE AU - W.H. Nikolaizik AU - K. Trociewicz AU - F. Ratjen TI - Bronchial reactions to the inhalation of high-dose tobramycin in cystic fibrosis AID - 10.1183/09031936.02.00264002 DP - 2002 Jul 01 TA - European Respiratory Journal PG - 122--126 VI - 20 IP - 1 4099 - http://erj.ersjournals.com/content/20/1/122.short 4100 - http://erj.ersjournals.com/content/20/1/122.full SO - Eur Respir J2002 Jul 01; 20 AB - 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, β‐agonists in combination with the antibiotic inhalation are recommended.