Long-term tobramycin therapy in patients with cystic fibrosis and advanced pulmonary disease.

The aim of our clinical study was to find if prolonged tobramycin 
therapy can prevent further rapid deterioration in cystic fibrosis patients. Eleven 
courses of treatment were given to the nine patients. Eight of 
these markedly improved their physical activity and gained weight. However, only 
in four of these patients was clinical improvement correlated with an 
improved radiogram. Pseudomonas was eradicated from the sputum of only four 
patients during therapy but reappeared in three of them before the 
end of therapy. Clinical improvement and negligible side effects suggest treatment 
of exacerbating Pyocyaneus bronchopneumonia with prolonged tobramycin therapy. Dosage should be 
higher than 5 mg/kg/day with strict control of tobramycin blood level 
and awareness of side effects. 