What are the effects and side effects of Tobramycin Inhalation Solution?

It is an aminoglycoside antibiotic with a broad antibacterial spectrum. Its bactericidal mechanism is mainly to inhibit the protein synthesis of sensitive bacteria. Tobramycin is highly effective against Gram-negative bacilli, and its antibacterial activity against Pseudomonas aeruginosa is 2 to 8 times stronger than gentamicin.

About Tobramycin Inhalation Solution

The U.S. Food and Drug Administration (FDA) approved the marketing of tobramycin inhalation solution in 1998. In the United States, tobramycin inhalation solution is a first-line treatment drug for patients with cystic fibrosis (CF) combined with Pseudomonas aeruginosa (Pa) colonization and acute and chronic infections. It is approved for use in CF patients over 6 years old. Although data are limited in children younger than 6 years of age, the same dose is recommended.

Tobramycin inhalation solution

Tobramycin is an aminoglycoside antibacterial drug that mainly achieves its antibacterial purpose by inhibiting bacterial protein synthesis. It has weak adverse reactions and has a broad antibacterial spectrum. It is the preferred drug for the treatment of respiratory tract infections. In recent years, studies have found that inhaling tobramycin to treat CF lung infection can prevent the drug from passing through the air-liquid barrier and reduce the first-pass effect of the drug. It not only reduces the drug dose, but also increases the concentration of the drug in the lungs and reduces systemic adverse reactions.

Tobramycin Inhalation Solution Efficacy

Inhaled antibacterial drugs can reduce bacterial load and improve lung function in the treatment of CF and Pa infection. In particular, tobramycin inhaled solution has been studied the most. For patients with chronic Pa infection, it is recommended to inhale tobramycin solution on a long-term and periodic basis, alternating between 28 days of medication and 28 days of drug withdrawal, thereby reducing the amount of Pa bacteria and weakening its impact.

Tobramycin inhalation solution was evaluated in a large, multicenter, double-blind, placebo-controlled study.

Tobramycin inhalation solution is a dose of 300 mg twice daily. The drug is specially formulated so that it is preservative-free and has an osmotic pressure close to that of liquids on the airway surface.

This allows for inhalation of high doses of drug to achieve high concentrations in the airways and is more tolerable than parenteral formulations.

Compared with the placebo group, the tobramycin group had significantly increased lung function and significant differences in forced vital capacity and forced expiratory flow, decreased sputum bacterial density, and decreased the frequency of exacerbations.

At the end of treatment, microbiological test results showed that the treatment group showed better efficacy compared with the placebo group. The average sputum concentration of tobramycin after the first dose (695.6±817) μg/mL was similar to that measured after the last dose (716.9±799) μg/mL, both of which were better than the specific minimum inhibitory concentration tested. The incidence of drug-related adverse events was lower in the tobramycin group, and no evidence of renal or ototoxicity was observed.

Tobramycin Inhalation Solution Side Effects

The most common symptoms of tobramycin inhalation solution include: lung problems or worsening of cystic fibrosis, noisy breathing (rales), abnormal red blood cell activity, voice changes (hoarseness).

1. Lung problems or worsening of cystic fibrosis: If you develop symptoms of lung problems or worsening of cystic fibrosis, such as cough, difficulty breathing, etc., please inform your doctor immediately while using tobramycin inhalation solution. They may evaluate your symptoms and make adjustments or stop treatment as needed.

2. Noisy breathing (rales): If you have noisy breathing when using tobramycin inhalation solution, it is recommended to communicate with your doctor. They may check your respiratory tract and adjust your medication dosage or give appropriate treatment if needed.

3. Abnormal red blood cell activity: If you develop abnormal red blood cell activity, such as anemia or reduced hemoglobin, while using tobramycin inhalation solution, please inform your doctor. They may order blood tests to monitor your blood counts and take appropriate action as needed.

4. Voice changes (hoarseness): If your voice changes, such as becoming hoarse or hoarse, talk to your doctor after using tobramycin inhalation solution. They may evaluate your voice problem and provide appropriate management or adjustments to your treatment plan as needed.

Summary

Up to now, domestic pharmaceutical companies have applied to produce tobramycin inhalation solution, which will provide a strong guarantee for the standardized management of CF patients in my country. The Cystic Fibrosis Foundationpulmonary guideline recommends eradication treatment when Pa is first detected, that is, tobramycin inhalation solution (300 mg/time, bid) for 28 consecutive days.

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