I have lately been hearing about an antibiotic treatment called ”TOBI.” Could you explain what it is? What can we expect from this type of antibiotic or treatment?
TOBI is the brand name for a treatment known as TOBramycin for Inhalation. The principle for this kind of treatment is not new; tobramycin and other antibiotics, originally designed for intravenous use, have been administered in aerosol form at cystic fibrosis clinics for many years to control chronic bacterial infections of the bronchi, particularly Pseudomonas aeruginosa. The tobramycin intravenous solution is administered using a compressor and generic nebulizer, together with Ventolin. TOBI consists of 300 mg vials of tobramycin specially prepared for nebulization, allowing for stronger doses (600 mg per day compared with 160 to 320 mg per day for the intravenous solution). Treatments are given twice a day using a DeVilbiss PulmoAide compressor and a PARI LC PLUS nebulizer. TOBI is administered separately, because the bronchodilator treatment is given beforehand (metered-dose aerosol, powder or nebulizer). Diluting TOBI or mixing it with Pulmozyme (dornase alfa, recombinant) in the nebulizer is not recommended. During the clinical trials, participants who were receiving several treatments were instructed to take TOBI after the other treatments.
The main study on this treatment was done in the United States between 1995 and 1996. The results, which were published in 1999, showed 10% improvement in lung function compared with 2% deterioration with the placebo (inert substance). Hospitalization was less frequent and the number of days on intravenous antibiotic treatment decreased for TOBI users. However, no comparison has been made between the TOBI treatment and the traditional aerosolized tobramycin treatment offered in cystic fibrosis clinics. Nevertheless, TOBI has become more popular because of its proven safety and effectiveness, its specially designed formula for nebulization and its convenient format.