tobramycin inhalation / Generic mfg. - LARVOL DELTA

Fucose-tobramycin sponge-like microparticles to treat pulmonary Pseudomonas aeruginosa infections in a lectin-competitive approach. (PubMed, J Adv Res) - "This tobramycin spongy-like dry powder, identified as high lectin affinity and excellent respiratory variability tolerance, holds significant promise for the treatment of pulmonary infections."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Recurrent Lung Infections In A kidney Transplant Patient: A Diagnostic Clue Reveals CD19 Deficiency. (ACAAI 2025) - "Her immunosuppressive regimen included mycophenolate, tacrolimus, and prednisone, with recent addition of inhaled tobramycin. Discussion In kidney transplant recipients with recurrent infections, persistent CD19+ B cell deficiency—even in the presence of normal immunoglobulin levels—should prompt consideration of functional antibody defects. Early recognition by pre & post transplant Immunoglobulin levels and CD19 counts are key to optimizing outcomes in this vulnerable population."

Clinical • Immunology • Infectious Disease • Nephrology • Pneumococcal Infections • Pneumonia • Primary Immunodeficiency • Respiratory Diseases • Solid Organ Transplantation • Transplantation • CD4 • CD8

An Unusual Overlap: Coexisting Cystic Fibrosis and Common Variable Immunodeficiency-like Phenotype in an Adult Patient (ACAAI 2025) - "Despite being on an optimized CF regimen, including Trikafta, Pulmozyme, albuterol, olodaterol, and inhaled tobramycin, he experienced over 90 CF exacerbations. In patients with CF who continue to experience frequent exacerbations despite optimal management, further immunologic evaluation should be considered. Early identification and initiation of therapy may lead to improved outcomes"

Clinical • Bronchiectasis • Cystic Fibrosis • Genetic Disorders • Hepatology • Immunology • Infectious Disease • Pneumococcal Infections • Primary Immunodeficiency • Psychiatry • Pulmonary Disease • Respiratory Diseases • CD4

GRANULOMATOUS RESTRICTIVE LUNG DISEASE IN T-CELL ACTIVATION DYSFUNCTION AND HYPOGAMMAGLOBULINEMIA (CHEST 2025) - "The obstructive component of his lung disease was treated with a mometasone-formoterol combination inhaler, montelukast, cetirizine and Dupilumab, an IL-4 and IL-13 pathway inhibitor...In addition, he receives monthly IVIG infusions and bi-monthly inhaled tobramycin...GLILD treatment strategies typically include immunosuppressive agents such as glucocorticoids, rituximab, azathioprine, and mycophenolate mofetil [2]... The necrotizing nature of our patient's granulomas suggests a unique immune dysregulation mechanism, potentially involving defective granuloma resolution and chronic inflammation-driven airway remodeling. Given the absence of a confirmed genetic etiology, further molecular research is warranted to better understand the underlying immune dysfunction."

Asthma • Bronchiectasis • CNS Disorders • Endocrine Disorders • Epilepsy • Hypoparathyroidism • Immunology • Infectious Disease • Inflammation • Interstitial Lung Disease • Primary Immunodeficiency • Pulmonary Disease • Respiratory Diseases • Tuberculosis • Vasculitis • HAVCR2 • IFNG • IL13 • IL4

Ritedose Now Offers the Largest Nebulized Drug Portfolio in the U.S.: FDA Approves the Company to Manufacture Generic Tobramycin Inhalation Solution (The Manila Times) - "The Ritedose formulation is preservative-free and packaged as 300 mg doses in 5 ml ampules, to be administered through a nebulizer device. The medication is now available for purchase."

ANDA • Generic launch • Cystic Fibrosis • Infectious Disease

ENDOBRONCHIAL ASPERGILLOMA IN A LUNG TRANSPLANT PATIENT (CHEST 2025) - "He was started on posaconazole for treatment of invasive endobronchial aspergillosis. Antifungal prophylaxis with inhaled tobramycin and azole therapy remains key in protecting lung transplant patients against invasive infections. In this case, undertreatment of prior aspergillosis infection only treated with inhaled amphotericin likely increased his risk for inadequate treatment."

Clinical • Cardiovascular • Fibrosis • Infectious Disease • Interstitial Lung Disease • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Transplantation

Mucus-penetrating archaeolipid nanocarriers delivering Thymus vulgaris essential oil and tobramycin: A multifunctional approach against Pseudomonas aeruginosa biofilms and inflammation. (PubMed, Eur J Pharm Biopharm) - "Inhaled tobramycin (TB) is the standard antibiotic therapy but has limited efficacy due to poor biofilm penetration and bacterial tolerance, while Thymus vulgaris essential oil (EOT) provides antioxidant and anti-inflammatory effects but is hindered by low solubility and instability. Moreover, NAL-EOT/TB lowered ROS in neutrophil-like cells and achieved greater IL-8 reduction than dexamethasone. These findings support NAL-EOT/TB as a multifunctional nanotherapeutic platform to address mucus penetration, biofilm disruption, and airway inflammation in CF."

Journal • Cystic Fibrosis • Genetic Disorders • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases • CXCL8

A CAVITY WITHOUT CULTURE: CYTOPATHOLOGIC DIAGNOSIS OF ACTINOMYCES INFECTION (CHEST 2025) - "IV therapy directed at both pseudomonas and actinomyces was initiated with transition to 4 weeks of amoxicillin with outpatient follow-up...He has been maintained on alternating-month inhaled tobramycin and percussive therapy with continued low-grade hemoptysis but without recent bronchiectasis exacerbation requiring hospitalization... Actinomycosis is a rare infection caused by anerobic bacteria, which is commonly the result of aspiration. The imaging findings of actinomycosis are varied and therefore can present a diagnostic challenge. Careful review of nonmicrobiologic testing, such as cytopathology, may also reveal potential etiologies and lead to acceleration of appropriate workup and management to avoid further morbidity."

Bronchiectasis • Dental Disorders • Diabetes • Infectious Disease • Metabolic Disorders • Pulmonary Disease • Respiratory Diseases

CONVERSION OF CFTR-RELATED METABOLIC SYNDROME TO CYSTIC FIBROSIS BASED ON CLINICAL FEATURES (CHEST 2025) - "She completed eradication therapy with inhaled tobramycin and ciprofloxacin and subsequently started inhaled steroids, hypertonic saline, and chest physiotherapy. This case highlights the need for close monitoring of cystic fibrosis gene carriers during childhood. Despite initial screenings that place these individuals under the CRMS/CFSPID category, there remains a potential for these patients to have significant morbidity with high risk of affecting long-term health outcomes. By identifying emerging CF-related symptoms early, healthcare providers can better support these patients' health trajectories, leading to improved prognoses and quality of life."

Clinical • Bronchiectasis • Chronic Cough • Cough • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Metabolic Disorders • Otorhinolaryngology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Sinusitis • CFTR

Bacterial load, respiratory symptoms and inhaled antibiotic treatment in adults with bronchiectasis (WBC 2025) - "Inhaled tobramycin significantly alleviates respiratory symptoms in patients with bronchiectasis and P. aeruginosa infection, particularly in those with high baseline bacterial load. Improvements in cough, sputum, congestion, breathlessness and chest pain support its role as an effective symptom-targeted therapy for this population."

Clinical • Bronchiectasis • Cough • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Blood eosinophil counts, airway infections and inhaled antibiotic treatment in bronchiectasis (WBC 2025) - "We did a post-hoc analysis to determine the changes in BECs upon inhaled tobramycin and evaluated the therapeutic outcomes stratified by BECs levels... Higher BECs are associated with P. aeruginosa infection in bronchiectasis, correlating with more severe disease. Inhaled antibiotics may increase BECs and ameliorate symptoms, irrespective of baseline BECs levels."

Bronchiectasis • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Psychometric validation and determination of the minimal clinically important difference for the bronchiectasis health questionnaire in adults with bronchiectasis (WBC 2024) - "Methods We enrolled a cross-sectional observational cohort of 436 bronchiectasis patients and another cohort of 357 patients treated with tobramycin inhalation solution or saline inhalation for Pseudomonas aeruginosa infection in a randomized trial...The MCID for BHQ was consistently identified as 3 points. Conclusions The BHQ represents a clinically meaningful tool for evaluating therapeutic intervention outcomes and patient-centered outcomes."

Clinical • Bronchiectasis • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Efficacy and safety of inhaled tobramycin (Vantobra) in adult patients with bronchiectasis and P. aeruginosa in sputum: a prospective observational study (WBC 2024) - "Our findings indicate that Vantobra may be effective in eradicating PA and improving quality of life of bronchiectasis patients with a good safety profile."

Clinical • Observational data • Bronchiectasis • Infectious Disease • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases

Killing two birds with one stone: emergence of colistin and cefiderocol resistance in a mucoid MDR Acinetobacter baumannii under colistin pressure. (PubMed, Front Microbiol) - "Due to Pseudomonas aeruginosa infection, she received inhaled tobramycin and COL treatment. Considering that lung transplantation still represents a life-saving option for CF patient with advanced lung disease, this study highlights the critical need for careful administration of last-resort molecules in patients that may face immunosuppression. Indeed, given the possibility of simultaneous emergence of resistance and the limited treatment options available to patients infected with MDR A. baumannii, last-resort antibiotics should be spared to avoid selection of pan-resistant microorganisms."

Journal • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Transplantation

Changes in Medicaid claims for chronic medications for cystic fibrosis (NACFC 2025) - "Background: Several published reports have described changes in chronic medications for cystic fibrosis (CF) after the initiation of elexacaftortezacaftor-ivacaftor (ETI)...Prescriptions for inhaled tobramycin were difficult to differentiate from prescriptions for IV tobramycin, so we have not yet included tobramycin in our analysis... Prescriptions for dornase alfa and inhaled aztreonam decreased after the introduction of ETI, but to a greater extent than recorded in the CFFPR (approximately 15% and 25%, respectively). These results support the use of claims data to complement CFFPR analyses and prospective studies to understand changes in chronic CF medications use after ETI. Our analysis is limited by the inability to examine only people with CF, to determine if people with CF took the medications that were prescribed, or whether changes in medications occurred via shared decision-making with the CF care team."

Medicaid • Reimbursement • US reimbursement • Cystic Fibrosis • Genetic Disorders • Immunology • Respiratory Diseases

Azithromycin use in the UK and US and its effect on ppFEV1: A target trial emulation approach (NACFC 2025) - "Following the RCT eligibility criteria we restricted our analysis to PwCF aged 6–21, with baseline ppFEV1 ≥40%, and excluded users of AZ in the previous year, as well as users of dornase alfa, tobramycin, and inhaled steroids in the previous three months. Conclusions based on the trial emulations using UK and US registry data align with the conclusions reported in the published target trial. Target trial emulation is a promising framework for utilizing observational data found in registries and longitudinal cohorts to provide evidence, under certain assumptions, that may supplement evidence from RCTs. We show the utility of this method in CF registry data in the UK and the US."

Cystic Fibrosis • Genetic Disorders • Immunology • Respiratory Diseases

The role of Advanced Practice Providers (APPs) in the CF care community (NACFC 2025) - "Table 1 (abstract 390): Number of Medicaid prescription fills by year Percent change from 2018 to 2022 2018 2019 2020 2021 2022 Inhaled dornase alfa 70,330 69,972 68,351 63,994 59,251 -16% Inhaled aztreonam 5,716 5,947 5,230 4,425 3,792 -34% Inhaled tobramycin 11,420 11,523 10,351 9,904 8,890 -22% Pancreatic enzyme replacement therapy (PERT) 249,202 274,158 280,890 288,053 287,319 +15% Tezacaftor/ivacaftor 6,208 12,281 5,040 3,229 731 -88% elexacaftor/tezacaftor/ivacaftor (ETI) NA 2,245 34,631 46,943 56,184 +2,402% (2019 to 2022) A total of 103 responses were received. APPs serve a vital role of the clinical and non-clinical operations of CF care teams, but we lack understanding of the full scope of the work they encompass. A survey of the APP workforce demonstrated utilization in both inpatient and outpatient clinical environments and near-equal distribution across the lifespan. The survey also demonstrated that many APPs are working in non-clinical capacities,..."

Metastases • Cystic Fibrosis • Genetic Disorders • Immunology • Pediatrics • Respiratory Diseases

Population trends in medication utilization among people with CF enrolled in Medicaid (NACFC 2025) - "Prescription fills by year were obtained for four non-modulator treatments most specific to pwCF (inhaled dornase alfa, inhaled aztreonam, inhaled tobramycin, and PERT), and modulator therapies which became available between 2018–2022 (tezacaftor/ivacaftor in 2018 [2], elexacaftor/tezacaftor/ivacaftor [ETI] in 2019 [3]). Our study found after introduction of modulator therapies tezacaftor/ivacaftor and ETI, prescription fills decreased from 2018 to 2022 for inhaled dornase alfa, inhaled aztreonam, and inhaled tobramycin, but not PERT. One explanation for the lack of decrease in PERT prescription fills is that clinicians are not weaning PERT since pancreatic insufficiency remains persistent and is not resolved by modulator therapies; additionally patients may not be as burdened by treatment with oral PERT, compared to time-consuming inhaled therapies, and so feel less compelled to stop PERT, instead focusing on diet and gastrointestinal health. Another explanation for..."

Clinical • Medicaid • Reimbursement • US reimbursement • Cystic Fibrosis • Genetic Disorders • Immunology • Respiratory Diseases

Anti-Psl/PcrV bispecific monoclonal antibody improves bacterial clearance, reduces lung pathology caused by Pseudomonas aeruginosa isolates from cystic fibrosis children who failed eradication therapy (NACFC 2025) - "Background: Inhaled tobramycin (TOB) is routinely used to eradicate new-onset Pseudomonas aeruginosa (PA) infections in people with cystic fibrosis (pwCF) to prevent progression to chronic infection. Gremubamab potentiates neutrophil OPK of PA isolates 565P and 505P in vitro. A single prophylactic dose of gremubamab significantly improved bacterial clearance of 565P and 505P in vivo. Prophylactic treatment with the bispecific mAb in combination with TOB also suggests that combination therapy may further promote bacterial clearance compared to a single modality therapy and reduced against lung pathology."

Clinical • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Inflammation • Respiratory Diseases

Enhancing innovative therapies for pulmonary infections through liposomal encapsulation of tobramycin against Pseudomonas aeruginosa (ERS 2025) - "Inhaled tobramycin (TB) is a reference therapy, but the efficacy may be limited by its rapid clearance and limited penetration into the pulmonary mucus...Furthermore, in the APM model, LPPEG-TB demonstrated greater ability to migrate through the mucus layer compared to LP-TB and free TB. These results suggest that LPPEG-TB are promising candidates for treating P. aeruginosa pulmonary infections, as their increased ability to penetrate mucus reduces mucociliary clearance and their prolonged retention in the cell membrane before cellular uptake allows a more sustained antibacterial activity."

Infectious Disease • Respiratory Diseases

Study on Serum and Pulmonary Drug Concentrations, Pharmacokinetics/Pharmacodynamics, and Efficacy Evaluation of Long-Term Tobramycin Inhalation Solution Regimen in Bronchiectasis Patients with Pseudomonas aeruginosa Infection (ChiCTR) - P4 | N=24 | Not yet recruiting | Sponsor: The First Affiliated Hospital of Guangzhou Medical University; Joincare Pharmaceutical Group Industry Co.,Ltd

New P4 trial • Bronchiectasis • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Inhaled Tobramycin for Pseudomonas Eradication Post-Lung Transplantation (WTC 2025) - "Although challenging to manage, Psa eradication after lung transplantation is successful with inhaled tobramycin mono- or combination therapy. Successful eradication with inhaled tobramycin was more likely with earlier therapy initiation and reduction of immunosuppression."

Bronchiectasis • Infectious Disease • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases • Transplantation

Pulmonary delivery of excipient-free tobramycin DPIs for the treatment of Pseudomonas aeruginosa lung infection with CF. (PubMed, Front Pharmacol) - "This study demonstrates that excipient-free tobramycin inhalable powder with good delivery and deposition performance can be successfully obtained using the SFD method. Inhalation of excipient-free tobramycin inhalable powder has the potential to be a promising strategy for treating pulmonary infections caused by P. aeruginosa in patients with CF."

Journal • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Effective Pseudomonas aeruginosa Eradication in Cystic Fibrosis: Multicenter Study. (PubMed, Clin Pediatr (Phila)) - "The revised protocol achieved a high PA eradication rate in CF patients. Adapting treatment regimens based on PA characteristics and patient condition can optimize outcomes and improve CF management."

Clinical • Journal • Cystic Fibrosis • Genetic Disorders • Immunology • Pulmonary Disease • Respiratory Diseases

Inhaled Tobramycin Usage in Critically Ill Pediatric Patients Without Cystic Fibrosis: A Pediatric Pharmacy-Association, Practice-Based Research Network Survey Study. (PubMed, J Pediatr Pharmacol Ther) - "Most respondents did not have a standardized inhaled tobramycin protocol. There are variations in the dosage regimen, administration, and monitoring practices in critically ill children receiving inhaled tobramycin. Pediatric clinical pharmacists should work with interprofessional teams, including respiratory therapists and providers, to standardize the use of inhaled antibiotics."

Journal • Acute Kidney Injury • Cardiovascular • Critical care • Cystic Fibrosis • Genetic Disorders • Immunology • Nephrology • Pediatrics • Pulmonary Disease • Renal Disease • Respiratory Diseases