clinical trial of nebulised tobramycin or colistin

[Guest guest]

Hi,

this is an interesting comparison of TOBI and Colistin. A four weeks

trial is a little short in my opinion. But for those who have

problems with the insurance to cover TOBI it's good argument, since

the results with TOBI were much better than with Colistin.

Peace

Torsten

Eur Respir J 2002 Sep;20(3):658-64 Related Articles, Links

A randomised clinical trial of nebulised tobramycin or colistin in

cystic fibrosis.

Hodson ME, Gallagher CG, Govan JR.

Royal Brompton & Harefield NHS Trust, London, UK. s.hockley@...

Chronic infection with Pseudomonas aeruginosa is associated with

progressive deterioration in lung function in cystic fibrosis (CF)

patients. The purpose of this trial was to assess the efficacy and

safety of tobramycin nebuliser solution (TNS) and nebulised colistin

in CF patients chronically infected with P. aeruginosa. One-hundred

and fifteen patients, aged > or = 6 yrs, were randomised to receive

either TNS or colistin, twice daily for 4 weeks. The primary end

point was an evaluation of the relative change in lung function from

baseline, as measured by forced expiratory volume in one second %

predicted. Secondary end points included changes in sputum P.

aeruginosa density, tobramycin/colistin minimum inhibitory

concentrations and safety assessments. TNS produced a mean 6.7%

improvement in lung function (p=0.006), whilst there was no

significant improvement in the colistin-treated patients (mean change

0.37%). Both nebulised antibiotic regimens produced a significant

decrease in the sputum P. aeruginosa density, and there was no

development of highly resistant strains over the course of the study.

The safety profile for both nebulised antibiotics was good.

Tobramycin nebuliser solution significantly improved lung function of

patients with cystic fibrosis chronically infected with Pseudomonas

aeruginosa, but colistin did not, in this study of 1-month's

duration. Both treatments reduced the bacterial load.

PMID: 12358344 [PubMed - in process]