{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T23:23:11Z","timestamp":1781220191962,"version":"3.54.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,11,12]],"date-time":"2013-11-12T00:00:00Z","timestamp":1384214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Aerosol Medicine and Pulmonary Drug Delivery"],"published-print":{"date-parts":[[2014,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Repeated courses of intravenous (IV) aminoglycosides in cystic fibrosis (CF) patients are associated with cumulative nephrotoxicity. Targeting their delivery through the inhaled route during acute pulmonary exacerbations may also be effective, but without systemic side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Using a randomized crossover trial design, in a pilot study we compared 14 days of IV tobramycin with nebulized tobramycin 300\u2009mg twice a day (TNS) in acute respiratory exacerbations in 20 CF adults chronically infected with\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa (Psa)<\/jats:italic>\n                      . Patients also received IV colistin in both arms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Improvement in spirometry was similar between the two groups [mean change in FEV\n                      <jats:sub>1<\/jats:sub>\n                      % predicted: IV group 16.4 (standard deviation 8.5) versus TNS group 19.9 (11.3),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.26], but there was more suppression of sputum\n                      <jats:italic toggle=\"yes\">Psa<\/jats:italic>\n                      in the TNS group [mean difference between treatments 0.85 log\n                      <jats:sub>10<\/jats:sub>\n                      colony-forming units\/mL (CI 0.03 to 1.67),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.05]. IV tobramycin was associated with a greater urinary protein leak [mean difference between treatments 0.59\u2009mg\/24\u2009hr (0.30 to 0.87),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.0005] and higher urinary levels of markers of acute renal tubular injury:\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      -acetylglucosaminidase [0.72\u2009IU\/mmol (0.37 to 1.07),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.0004], alanine aminopeptidase [1.19\u2009IU\/mmol (0.70 to 1.68),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.0001], and \u03b2\n                      <jats:sub>2<\/jats:sub>\n                      -microglobulin [0.44\u2009\u03bcg\/mmol (0.16 to 0.72),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.0046] than TNS. Compared with IV tobramycin, TNS treatment prolonged the time to next exacerbation requiring hospitalization (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001). Patient satisfaction was similar with both treatments, and no serious adverse effects were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      TNS is effective in treating acute exacerbations of\n                      <jats:italic toggle=\"yes\">Psa<\/jats:italic>\n                      in CF patients, but with a renal sparing potential compared with the IV preparation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jamp.2013.1055","type":"journal-article","created":{"date-parts":[[2013,11,12]],"date-time":"2013-11-12T12:40:42Z","timestamp":1384260042000},"page":"299-305","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Nebulized Tobramycin in the Treatment of Adult CF Pulmonary Exacerbations"],"prefix":"10.1177","volume":"27","author":[{"given":"Mohamed","family":"Al-Aloul","sequence":"first","affiliation":[{"name":"University Hospital of South Manchester","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilip","family":"Nazareth","sequence":"additional","affiliation":[{"name":"Liverpool Heart and Chest Hospital NHS Trust","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Walshaw","sequence":"additional","affiliation":[{"name":"Liverpool Heart and Chest Hospital NHS Trust","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,11,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20138"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(82)90387-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02550321"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/26.9.1251"},{"key":"e_1_3_3_6_2","first-page":"163","article-title":"Beta 2-microglobulin: its significance and clinical usefulness","volume":"20","author":"Bethea M","year":"1990","unstructured":"Bethea M, , and Forman DT: Beta 2-microglobulin: its significance and clinical usefulness. 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