title: Once daily aerosolised tobramycin in adult patients with cystic fibrosis in the management ofPseudomonas aeruginosachronic infection.
abstract: It is estimated that about 60-70% of Cystic Fibrosis patients developPseudomonas aeruginosachronic infection, with progressive loss of lung function, as well as increased antibiotic resistance and mortality. The current strategy is to maintain lung function by chronic suppressive antipseudomonas antibiotic therapy. Tobramycin inhalation solution was the first approved aerosolised antibiotic to be used againstP. aeruginosa; inhalatory tobramycin frequency of administration is twice daily and inhalation time is estimated to be 15 to 20 min. From the pharmacokinetic point of view, aminoglycosides are dose-dependent antibiotics and therefore once-daily dosing intravenous regimens have shown to be superior to the conventional multiple daily dosing. Therefore, there is no pharmacological reason to prefer the b.i.d administration as it is usually performed in current clinical practice. Should this be confirmed also for inhalatory route, the use of once-daily dosed aerosolized tobramycin could be an important step in making treatment burden easier in CF patients. The aim of this proof of concept study was to explore the effectiveness of treatment with once daily inhaled tobramycin in reducingP. aeruginosa density in sputum of chronically infected patients.
authors.affiliation: Department Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, 20122 Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mantero
authors.affiliation: Department Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, 20122 Italy.
authors.forename: Andrea
authors.identifier: 0000-0001-5562-3131
authors.initials: A
authors.lastname: Gramegna
authors.affiliation: Department Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, 20122 Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pizzamiglio
authors.affiliation: Department Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, 20122 Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: D'Adda
authors.affiliation: Department Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, 20122 Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tarsia
authors.affiliation: Department Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, 20122 Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
keywords: Aerosolised antibiotic therapy; Cystic fibrosis; P. aeruginosa chronic infection; Tobramycin