Guest guest Posted June 13, 2001 Report Share Posted June 13, 2001 Hi, I read an interesting report about the most important speeches at the NACFC in Baltimore. One of those from Dr. LiPuma about the long term use of TOBI is not on the highlights-CD, so I can only quote from the summary I've read in that CF-Report from Roche. Dr. LiPuma reported, that after two years of using TOBI (28 days on/off) the PFTs of the patients still were better than before the study. Given that usually the yearly decline of the lung function is 3 %, that's a very promising result. BUT (and there's always a BUT, right) the number of pseudomonas strains rose, that were resistant to tobramycin concentrations below 16 nanogram/ml. While that's no problem for TOBI, because you reach significantly higher concentrations in the airways through inhalation, it's above the upper limit of parenteral therapy (IV's). This may cause two problems. First parenteral application of tobramycin alone is no longer effective against such strains and second your standard lab report will say, that your pseudomonas is resistant to tobramycin. Docs, who don't know what that means (and unfortunately there are some less educated ones out there) probably won't prescribe TOBI any longer, because they think that the pseudomonas is resistant to the higher tobra concentrations too. Bye Torsten, dad of Fiona 4wcf e-mail: aberdeen95@... Quote Link to comment Share on other sites More sharing options...
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