One type of bacterial infection common among cystic fibrosis patients is Pseudomonas Aeruoginosa (PA.) This microorganism can be difficult to treat because its structure offers it some degree of defense against antibiotic therapy. Once PA has infected its host, getting rid of it is difficult, especially for patients who have decreased lung function because of mucus blocking the airways. Patients who have persistent and ongoing infections of PA, even when treated with antibiotics, are said to be colonized with it.

1) Aerosolized

Preventing colonization is an important aspect of preserving overall health and lung function. Inhaled antibiotics, as opposed to those in pill form, have been shown to be more effective against PA. Tobramycin is one such antibiotic that has been studied in order to determine if it is useful in preventing or impeding the progress of PA. One study demonstrated that treatment with aerosolized tobramycin at the earliest onset of P. Aeruginosa infection was successful in preventing the infection from progressing further.

The brand name TOBI is a formulation of tobramycin previously available from Chiron pharmaceuticals. It has since been taken over by the company Novartis. TOBI is prescribed as a twice daily nebulized (aerosolized) medication given for a course of 28 days followed by 28 days without it. Most doctors who prescribe TOBI or tobramycin for inhalation also prescribe another type of inhaled antibiotic to be taken in the "off" months.

Although not all CF specialists support its use at this time, tobramycin is also available in a preservative free formula for use in the eFlow.

2) Intravenous

Cystic fibrosis patients are also prescribed tobramycin to be administered intravenously during a "tune-up" or as part of the treatment for a pulmonary exacerbation. Tobramycin is a twice daily infusion, that must be monitored closely in order to minimize its toxicity to other body organs. A tobramycin peak and trough is a blood test that is done to measure the amount of tobramycin in the blood stream at its highest (just after an infusion) and lowest (prior to an infusion) concentrations.

Tobramycin for intravenous administration has recently become available in the EclipseBall delivery format. Many cystic fibrosis patients prefer this type of delivery because it is silent and discrete.

3) Inhalation Power

Current trial studies are being done to determine the effectiveness of tobramycin as an inhalation powder.

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