Aerosolised tobramycin’s high sputum concentrations “significantly” improve the therapeutic ratio compared to parenteral aminoglycosides in patients suffering from cystic fibrosis. American researchers – the lead author was from Nemours Children’s Clinic, Orlando – used data obtained during two randomised, double blind, placebo-controlled studies with identical designs to assess pharmacokinetics of aerosolised tobramycin.
During the studies, 258 patients with cystic fibrosis received tobramycin 300 mg twice daily. Patients took aerosolised tobramycin for 28 days and then received no drug for a further 28 days, which constituted a cycle. Patients received three treatment cycles.
The authors estimated that the mean peak concentration of tobramycin in sputum was 1237 microg/g. Around 95 percent of patients attained tobramycin sputum concentrations that were more than 25 times the minimum inhibitory concentration for the Pseudomonas aeruginosa isolates.
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