To compare two treatment regimens using the antibiotic Tobramycin, in patients with Cystic Fibrosis (CF), when having their first respiratory infection with the bacteria Pseudomonas aeruginosa.
Why is this important?
Randomized controlled trials have found that both inhaled Tobramycin (80 mg/2 ml twice daily, typically for 365 days) or Tobramycin inhalation solution (TIS) (300 mg/5 ml twice daily, typically for 28 days) are able to eradicate P. aeruginosa from the airways of children with CF. No one has investigated whether these two treatments are comparable in clinical settings where not all patients have access to all treatments due to cost, or where not all are compliant with treatment protocols.
What did you do?
We looked back at the treatment of 65 children with CF who were infected with P. aeruginosa for the first time, and determined whether they received inhaled Tobramycin or TIS. We then looked to see how many children in each group were still infected with P. aeruginosa after they finished treatment.
What did you find?
Treatment with inhaled Tobramycin for 1 year, or with TIS for 1 month, appeared to have similar results in eradication of P. aeruginosa.
What does this mean and reasons for caution?
Both treatments can successfully eradicate P. aeruginosa from the lungs of children with CF, and the shorter treatment course may be more convenient for patients. With only 65 children, this study was much smaller than the clinical trials previously conducted. Prospective comparison of these treatments will be needed to determine if these findings are valid.
Both treatments showed similar results, but a few children in both groups failed to eradicate P. aeruginosa. Further work is necessary to find out why some children respond to this therapy and others do not.