Tobramycin inhalation powder (TOBI Podhaler) for the treatment of lung infection in patients with cystic fibrosis

Expert Rev Anti Infect Ther. 2016;14(1):9-17. doi: 10.1586/14787210.2016.1118344. Epub 2015 Dec 4.

Abstract

Cystic fibrosis (CF) is an autosomal recessive inherited disease secondary to a defect in the CF transmembrane conductance regulator gene (CFTR). Mortality in CF is associated with impairment of lung function in which bacterial infection plays a fundamental role. The microorganism Pseudomonas aeruginosa (P. aeruginosa) is a marker of poor prognosis. Tobramycin was the first parenteral antibiotic to be used as inhaled medication in CF. Owing to its beneficial effects; it was subsequently used in designed inhaled formulations. The first formulation was the inhalation solution, which improved lung function, lowered hospitalization rates, and reduced the courses of intravenous antibiotic. However, the high associated costs and time necessary to administer the medication negatively affected quality of life. The recent development of tobramycin inhalation powder has optimized treatment. The dry powder inhaler is a simple device that reduces administration time and improves adherence. As there is no risk of bacterial contamination, disinfection is unnecessary.

Keywords: Cystic fibrosis; Pseudomonas aeruginosa; chronic infection; tobramycin; tobramycin dry powder.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Aerosols
  • Anti-Bacterial Agents / therapeutic use*
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / microbiology
  • Cystic Fibrosis / pathology
  • Dry Powder Inhalers
  • Humans
  • Lung / drug effects
  • Lung / microbiology
  • Lung / pathology
  • Opportunistic Infections / complications
  • Opportunistic Infections / drug therapy*
  • Opportunistic Infections / microbiology
  • Opportunistic Infections / pathology
  • Prognosis
  • Pseudomonas Infections / complications
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas Infections / pathology
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / pathogenicity
  • Pseudomonas aeruginosa / physiology
  • Quality of Life
  • Respiratory Tract Infections / complications
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / pathology
  • Tobramycin / therapeutic use*
  • Treatment Outcome

Substances

  • Aerosols
  • Anti-Bacterial Agents
  • Tobramycin