title: Tobramycin  for the treatment of bacterial pneumonia in children.
abstract: BACKGROUND
  Common etiological agents for community-acquired lower respiratory tract infection (LRTI) include Streptococcus pneumoniae, Hemophilus influenzae and Mycoplasma pneumoniae and can be easily managed with oral or intravenous antibiotics. However, LRTI in patients with underlying illnesses, such as cystic fibrosis (CF) and immune deficiency, or on ventilator support is difficult to manage because these are caused by Gram-negative bacilli. Tobramycin has been shown to be effective in the management of these patients.
  
  
  METHODS
  Information about the antimicrobial activity, pharmacological aspects (including pharmacokinetics and pharmacodynamics), clinical efficacy, safety and side effects of tobramycin have been covered in this review.
  
  
  CONCLUSIONS
  A major advance for the use of tobramycin has occurred with its use by the inhalational route, in children with CF. The inhalation route provides the advantage of ease of administration for prolonged periods at home and allows use of very high doses. Systematic reviews suggest that tobramycin inhalation improves outcome, decreases the need for hospitalization and decreases the need for use of frequent systemic antibiotics in CF patients colonized with pseudomonas. Data on the efficacy of inhaled tobramycin in non-CF bronchiectasis are scarce, as are data on the prevention and treatment of ventilator-associated pneumonia, and on the role of combining inhaled tobramycin with systemic tobramycin. Despite limitations, this drug has the potential to be used in various conditions other than CF.
authors.affiliation: All India Institute of Medical Sciences, Department of Pediatrics, New Delhi 110029, India.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Bothra
authors.forename: Rakesh
authors.initials: R
authors.lastname: Lodha
authors.forename: Sushil Kumar
authors.initials: SK
authors.lastname: Kabra
mesh_terms: D000280:Administration, Inhalation; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000494:pharmacology*; D002648:Child; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000378:metabolism*; D016032:Randomized Controlled Trials as Topic; D014031:Tobramycin / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000494:pharmacology*
chemical_list: D000890:Anti-Infective Agents; D014031:Tobramycin