Evaluation of long term tobramycin therapy in patients with cystic fibrosis and advanced pulmonary disease.

To nine cystic fibrosis patients with chronic bronchopulmonary infection of severely damaged 
lungs invaded by Pseudomonas aeruginosa, eleven courses of prolonged tobramycin treatment 
(5 mg/kg/day) for four to 16 weeks were administered. Pulmonary symptoms 
improved and a better quality of life was achieved in all 
but one patient. Objective parameters (chest X-ray, pulmonary function tests) changed 
to a lesser extent. In only one patient was Pseudomonas eradicated 
from the sputum but reappeared after discontinuation of therapy. In the 
rest of the patients Pseudomonas was significantly suppressed or replaced by 
other pathogens. Four patients showed rises of antibody titres to Candida 
and two to Aspergillus fumigatus. No nephrotoxic side effects were observed, 
but vestibular function was reversibly impaired in one patient without corresponding 
clinical symptoms. No bacterial resistance to tobramycin was observed during therapy. 
