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Inhaled tobramycin in children with acute bacterial rhinopharyngitis

A Varricchio1, D Tricarico, A De Lucia

  • 1Dipartimento Universitario di Patologia della Testa e del Collo, del Cavo Orale e della Comunicazione Audio-Verbale, Seconda Università degli Studi di Napoli, Naples, Italy.

International Journal of Immunopathology and Pharmacology
|March 30, 2006
PubMed

Insights

Inhaled tobramycin effectively treated acute bacterial rhinopharyngitis in children, showing superior results compared to oral amoxicillin/clavulanate. This topical antibiotic offers a safe and simple alternative for pediatric respiratory infections.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Antibiotic overuse for rhinopharyngitis contributes to antibiotic resistance.
  • Topical antibiotic administration may mitigate resistance development.
  • Acute bacterial rhinopharyngitis requires effective and safe treatment options for children.

Purpose of the Study:

  • To evaluate the efficacy and safety of inhaled tobramycin for acute bacterial rhinopharyngitis in children.
  • To compare inhaled tobramycin with oral amoxicillin/clavulanate in pediatric patients.
  • To assess the impact on clinical symptoms and objective measures of nasal and middle ear inflammation.

Main Methods:

  • A randomized, parallel-group, double-blind trial involving children aged 3-6 years with acute bacterial rhinopharyngitis.
  • Treatment groups received either inhaled tobramycin (15 mg) or oral amoxicillin/clavulanate (50 mg/Kg) twice daily for 10 days.
  • Outcome measures included nasal obstruction, mucopurulent rhinorrhea, post-nasal drip, adenoidal hypertrophy, tympanic inflammation, tympanometry, rhinomanometry, and microbial cultures.

Main Results:

  • Both treatments significantly improved all assessed parameters (p<0.01).
  • Inhaled tobramycin demonstrated superior improvement in nasal obstruction (p<0.05), adenoidal hypertrophy (p<0.01), tympanic inflammation (p<0.01), rhinomanometry (p<0.01), and culture outcomes (p<0.05) compared to oral amoxicillin/clavulanate.
  • 311 children completed the study, with 156 in the tobramycin group and 155 in the amoxicillin/clavulanate group.

Conclusions:

  • Inhaled tobramycin is a safe, effective, and user-friendly treatment for acute bacterial rhinopharyngitis in children.
  • This therapeutic approach may help reduce the incidence of antibiotic resistance.
  • Inhaled tobramycin presents a promising alternative to systemic antibiotics for pediatric respiratory tract infections.

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