NICE recommends inhaled antibacterials in cystic fibrosis

The tobramycin dry powder inhaler (TOBI Podhaler) is recommended for treating chronic pulmonary infections caused by Pseudomonas aeruginosa in patients with cystic fibrosis.

Patients are eligible for treatment if nebulised tobramycin is considered appropriate, ie, colistimethate sodium is contraindicated, is not tolerated or has not produced an adequate response, and only if the manufacturer supplies the product with the discount agreed as part of the patient access scheme.

NICE also recommends colistimethate sodium powder for inhalation (Colobreathe) for patients with chronic P. aeruginosa infection who would benefit from continued colistimethate treatment but who do not tolerate the drug in nebulised form and would therefore be considered for tobramycin therapy. Again, NICE has specified that the drug must be provided with the discount agreed as part of the patient access scheme. However, Colobreathe has yet to be launched in the UK.

NICE guidance on inhaled tobramycin and colistimethate

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