Inhaled versus nebulised tobramycin: A real world comparison in adult cystic fibrosis (CF)

Abstract

Inhaled powder tobramycin in CF is associated with improved adherence, tolerability and decreased exacerbation rates compared to nebulised treatment in real-life practice.

Inhaled Antibiotics for Gram-Negative Respiratory Infections

“…For example, inhaled tobramycin powder has been shown to improve adherence, decrease the need for adjunct intravenous (i.v.) antibiotic courses, and improve patient preference compared to a tobramycin inhalation solution in adult patients with CF (86). In contrast, an older study showed that tobramycin inhalation powder achieved similar reductions in P. aeruginosa density and increases in lung function (percent forced expiratory volume in 1 s [FEV 1 ]) compared to the solution but caused more coughing and had a higher discontinuation rate.…”

Reply to the comment by de Boer and Hoppentocht on: Inhaled Antimicrobial therapy – Barriers to effective treatment, by J. Weers, Adv. Drug Deliv. Rev. (2015), http://dx.doi.org/10.1016/j.addr.2014.08.013

“…In fact, the results for TOBI Podhaler in the clinic and in real-life practice would seem to suggest the opposite (see quotes from clinicians below). "Inhaled powder tobramycin in CF is associated with improved adherence, tolerability, and decreased exacerbation rates compared to nebulized treatment in real-life practice" [19]. "Treatment satisfaction was significantly higher for TIP for effectiveness, convenience, and global satisfaction" [20].…”

Reply to the comment by Cipolla et al. on: Inhaled antimicrobial therapy—Barriers to effective treatment, by J. Weers, Adv. Drug Deliv. Rev. (2015), http://dx.doi.org/10.1016/j.addr.2014.08.013

“…Nonetheless, TOBI Podhaler provides a valuable option for administration of aminoglycosides with a significantly lower burden of treatment. Moreover, if the results of the Harrison study [6] hold true across the CF patient population, the decreased treatment burden may translate into improved adherence and treatment outcomes. For those patients who cannot tolerate TOBI Podhaler or simply prefer the nebulizer, the TOBI product remains a valuable treatment option.…”

“…Additional long-term safety studies and 'real-world' investigator trials have been published since the review was drafted [5,6]. These studies continue to reflect positively on the safety and tolerability of TOBI Podhaler.…”

“…In another study [6], adult patients with CF (n = 78) commenced treatment with TOBI Podhaler following treatment in the previous 12 months with TOBI. The authors concluded that inhaled TOBI Podhaler in CF is associated with improved adherence, tolerability and decreased exacerbation rates compared to nebulized treatment in real-life practice.…”