Journal of Cystic Fibrosis
Volume 9, Issue 4 , Pages 292-295, July 2010

Serum tobramycin levels following delivery of tobramycin (Tobi®) via eFlow® advanced nebuliser in children with cystic fibrosis☆

  • E.L. Guy

      Affiliations

    • Leeds Regional Paediatric Cystic Fibrosis Centre, St James's University Hospital, Leeds, LS9 7TF, United Kingdom
    • Corresponding Author InformationCorresponding author. Tel.: +44 113 2065200; fax: +44 113 2067011.
    • ,
  • M. Bosomworth

      Affiliations

    • Department of Biochemistry, St James's University Hospital, Leeds LS9 7TF, United Kingdom
    • ,
  • M. Denton

      Affiliations

    • Department of Microbiology, St James's University Hospital, Leeds LS9 7TF, United Kingdom
    • ,
  • S.P. Conway

      Affiliations

    • Leeds Regional Paediatric Cystic Fibrosis Centre, St James's University Hospital, Leeds, LS9 7TF, United Kingdom
    • ,
  • K.G. Brownlee

      Affiliations

    • Leeds Regional Paediatric Cystic Fibrosis Centre, St James's University Hospital, Leeds, LS9 7TF, United Kingdom
    • ,
  • T.W.R. Lee

      Affiliations

    • Leeds Regional Paediatric Cystic Fibrosis Centre, St James's University Hospital, Leeds, LS9 7TF, United Kingdom

Received 8 December 2009; received in revised form 2 March 2010; accepted 15 March 2010.

Abstract 

Background

Safety and toxicity data for nebulised tobramycin are mainly derived from use of the Pari LC® Plus nebuliser, yet many centres are now using advanced nebulisers, such as the eFlow®.

Methods

Ten children (ages 2–16years) receiving 300mg TOBI® via eFlow® for clinical reasons participated. Serum tobramycin levels were obtained 1h post nebulisation. Nine provided samples for urinary NAG, and 10 underwent audiology.

Results

Tobramycin levels were >1mg/L in 3 children (maximum 3.8, 2 children aged 2years). Urine NAG/creatinine levels were raised (>0.94μmol/min/mmol) in 5 children, 1 of these had a tobramycin level of >1mg/L. One patient had high frequency hearing loss.

Conclusion

Serum tobramycin levels over 1mg/L can occur 1h post 300mg TOBI® delivered by eFlow®. Raised urinary NAG levels suggest that some children may have some associated early renal toxicity.

Keywords: Cystic fibrosis, Paediatric, TOBI, eFlow, Pseudomonas aeruginosa

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☆ The title has been presented as a poster at the 32nd European Cystic Fibrosis Conference, 10–13th June 2009, Brest, France.

PII: S1569-1993(10)00034-2

doi:10.1016/j.jcf.2010.03.007

Journal of Cystic Fibrosis
Volume 9, Issue 4 , Pages 292-295, July 2010

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