What is the effect of tobramycin inhalation solution in treating bronchiectasis

The efficacy of tobramycin inhalation solution in the treatment of bronchiectasis

The specification of tobramycin inhalation solution is 5ml:300mg. It is suitable for adults with bronchiectasis associated with pulmonary Pseudomonas aeruginosa infection. It can significantly reduce sputum PA load, reduce 24-hour sputum volume, reduce sputum purulence score, and significantly improve the patient's quality of life. Tobramycin inhalation solution independently developed by Health$ is an improved new drug developed in response to the high prevalence of bronchiectasis and the lack of clinical drugs in my country. Tobramycin is an aminoglycoside antibiotic with low clinical resistance and is used as the first-line treatment for early pulmonary Pseudomonas aeruginosa infection.

Experimental effect of tobramycin inhalation solution in the treatment of bronchiectasis

The purpose of a trial: to observe the clinical nursing methods and efficacy of ultrasonic aerosol inhalation of tobramycin in patients with bronchiectasis.

Test methods

There were 96 patients with bronchiectasis diagnosed and treated in the hospital. They were divided into two groups, with 48 cases in each group. The patients in the control group were given intravenous infusion treatment of ceftazidime and basic care. The research group was given tobramycin aerosol inhalation treatment and care on the basis of the control group. The effects and adverse reactions of the two groups of patients after treatment and care were observed.

Test results

The total effective rate of the study group was 89.58%, and that of the control group was 60.42%. The difference between the two groups was obvious and statistically significant (P<0.05); there was no significant difference in adverse reactions between the two groups of patients, and there was no statistical significance (P>0.05).

Test conclusion

Bronchiectasis is treated with anti-infective drugs combined with ultrasonic aerosol inhalation of tobramycin, and combined with corresponding clinical nursing methods, the effectiveness of the treatment can be significantly improved and is worthy of clinical promotion and application.

Another trial

There are few large-scale studies demonstrating the efficacy of nebulized tobramycin in bronchiectasis. A trial evaluated the efficacy and safety of nebulized inhalation (TIS) in adults with bronchiectasis and Pseudomonas aeruginosa infection.

Research methods

This was a 16-week, phase 3, multicenter, randomized, double-blind, placebo-controlled trial (NCT03715322). Eligible adult patients with bronchiectasis were recruited. On the basis of routine care, patients inhaled TIS (tobramycin inhalation solution, 300 mg/5 ml, twice a day) or normal saline (5 ml, twice a day) via a vibrating mesh nebulizer. Treatment was divided into two cycles, each consisting of 28 days of treatment and 28 days of non-treatment. Primary endpoints included changes from baseline in Pseudomonas aeruginosa density and bronchiectasis respiratory symptom quality of life scores at day 29.

Test results

The modified intention-to-treat population included 167 patients in the tobramycin group and 172 patients in the placebo group. Compared with the placebo group, the tobramycin inhalation solution group significantly reduced Pseudomonas aeruginosa density on day 29 (adjusted mean difference, 1.74 log10 colony forming units/g; 95% CI, 1.12-2.35; P < .001) and significantly improved bronchiectasis respiratory symptom quality of life scores (adjusted mean difference, 7.91; 95% CI, 5.72-10.11; P < .001). .001). Similar results were observed on day 85.

TIS significantly reduced 24-hour sputum volume and sputum turbidity scores on days 29, 57, and 85. More patients in the tobramycin inhalation solution group had negative Pseudomonas aeruginosa cultures on day 29 compared with the placebo group (29.3% vs. 10.6%). Adverse event and serious incidence rates were comparable between the two groups.

Research conclusion

TIS (tobramycin inhalation solution) is an effective treatment option with an acceptable safety profile for patients with bronchiectasis associated with Pseudomonas aeruginosa infection.

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参考文献

[1] Li Yanhong. Clinical nursing observation on the application of ultrasonic atomized inhalation of tobramycin in patients with bronchiectasis [J]. China Health Industry, 2014, 11(2):2.DOI:CNKI:SUN:WSCY.0.2014-02-026.

[2.]Guan WJ, Xu JF, Luo H, Xu XX, Song YL, Ma WL, Liang ZA, Liu XD, Zhang GJ, Zhang XJ, Li RK, Zhu SY, Zhang YJ, Cai XJ, Wei LP, Tian DB, Zhao H, Chen PY, Qu JM, Zhong NS; TORNASOL Study Group. A Double-Blind Randomized Placebo-Controlled Phase 3 Trial of Tobramycin Inhalation Solution in Adults With Bronchiectasis With Pseudomonas aeruginosa Infection. Chest. 2023 Jan;163(1):64-76. doi: 10.1016/j.chest.2022.07.007. Epub 2022 Jul 19. PMID: 35863486.