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Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review
From its introduction, the antibiotic tobramycin has been an important tool in the management of persons with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa lung infections. Initially an intravenous rescue treatment for pulmonary exacerbations, tobramycin delivered by inhalation has become...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417888/ https://www.ncbi.nlm.nih.gov/pubmed/22915944 http://dx.doi.org/10.2147/MDER.S16360 |
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author | VanDevanter, Donald R Geller, David E |
author_facet | VanDevanter, Donald R Geller, David E |
author_sort | VanDevanter, Donald R |
collection | PubMed |
description | From its introduction, the antibiotic tobramycin has been an important tool in the management of persons with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa lung infections. Initially an intravenous rescue treatment for pulmonary exacerbations, tobramycin delivered by inhalation has become a mainstay of chronic suppressive CF infection management. Platforms for tobramycin aerosol delivery have steadily improved, with increased lung deposition complimented by decreased device complexities, loaded tobramycin doses, delivery times, and treatment burdens. Most recently, a unique tobramycin inhalation powder (TIP) formulation with a portable delivery system, the TOBI(®) Podhaler(®) (Novartis AG, Basel, Switzerland) has been developed and approved in Europe, Canada, and Chile. Four capsules, each containing 28 mg of TIP are successively pierced and inhaled via the T-326 Dry Powder Inhaler Device (Novartis AG, Basel, Switzerland). No external power source is required to deliver an efficacious tobramycin dose in minutes. By comparison, tobramycin inhalation solution (TIS) (TOBI(®); Novartis), is delivered by LC(®) Plus (PARI Respiratory Equipment Inc, Midlothian, VA) jet nebulizer powered by an air compressor over 15–20 minutes. Comparative pharmacokinetics, safety, and efficacy studies of TIS and TIP in CF subjects with P. aeruginosa ≥ 6 years old demonstrate that: tobramycin lung deposition with 112 mg TIP is comparable to that attained with 300 mg TIS, TIP is more effective than placebo and not inferior to TIS with respect to pulmonary function benefit, and TIP has significantly faster treatment times and achieves higher patient satisfaction than TIS. TIP is associated with an increased frequency of mild to moderate local adverse events (cough, dysphonia, and dysgeusia) compared with TIS, however, these become less frequent as subjects gain TIP experience. These results suggest that the TOBI Podhaler may better meet the needs of many CF patients and families by reducing treatment time and complexity and improving patient satisfaction compared with TIS. |
format | Online Article Text |
id | pubmed-3417888 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-34178882012-08-22 Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review VanDevanter, Donald R Geller, David E Med Devices (Auckl) Review From its introduction, the antibiotic tobramycin has been an important tool in the management of persons with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa lung infections. Initially an intravenous rescue treatment for pulmonary exacerbations, tobramycin delivered by inhalation has become a mainstay of chronic suppressive CF infection management. Platforms for tobramycin aerosol delivery have steadily improved, with increased lung deposition complimented by decreased device complexities, loaded tobramycin doses, delivery times, and treatment burdens. Most recently, a unique tobramycin inhalation powder (TIP) formulation with a portable delivery system, the TOBI(®) Podhaler(®) (Novartis AG, Basel, Switzerland) has been developed and approved in Europe, Canada, and Chile. Four capsules, each containing 28 mg of TIP are successively pierced and inhaled via the T-326 Dry Powder Inhaler Device (Novartis AG, Basel, Switzerland). No external power source is required to deliver an efficacious tobramycin dose in minutes. By comparison, tobramycin inhalation solution (TIS) (TOBI(®); Novartis), is delivered by LC(®) Plus (PARI Respiratory Equipment Inc, Midlothian, VA) jet nebulizer powered by an air compressor over 15–20 minutes. Comparative pharmacokinetics, safety, and efficacy studies of TIS and TIP in CF subjects with P. aeruginosa ≥ 6 years old demonstrate that: tobramycin lung deposition with 112 mg TIP is comparable to that attained with 300 mg TIS, TIP is more effective than placebo and not inferior to TIS with respect to pulmonary function benefit, and TIP has significantly faster treatment times and achieves higher patient satisfaction than TIS. TIP is associated with an increased frequency of mild to moderate local adverse events (cough, dysphonia, and dysgeusia) compared with TIS, however, these become less frequent as subjects gain TIP experience. These results suggest that the TOBI Podhaler may better meet the needs of many CF patients and families by reducing treatment time and complexity and improving patient satisfaction compared with TIS. Dove Medical Press 2011-09-20 /pmc/articles/PMC3417888/ /pubmed/22915944 http://dx.doi.org/10.2147/MDER.S16360 Text en © 2011 VanDevanter and Geller, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. |
spellingShingle | Review VanDevanter, Donald R Geller, David E Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review |
title | Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review |
title_full | Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review |
title_fullStr | Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review |
title_full_unstemmed | Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review |
title_short | Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review |
title_sort | tobramycin administered by the tobi(®) podhaler(®) for persons with cystic fibrosis: a review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417888/ https://www.ncbi.nlm.nih.gov/pubmed/22915944 http://dx.doi.org/10.2147/MDER.S16360 |
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