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Alternative inhalation for Bramitop

Question
Dear expert team,
my son (31) inhales Bramitop (Tobramycin) and Colistin on/off. As soon as he changes to Bramitop, he hears himself double, which bothers him. In the time of Colistin inhalation the hearing changes return to normal still. I emphasize the word "still".
Are there any alternative inhalations that do not impair the hearing but are as effective or even better than Bramitop?
He has Pseudomonas 3 MRGN and the fungus Scedosporium prolificabs.
Many thanks
Answer
Hello,
especially aminogycosid antibiotics, to which Bramitop (Tobramycin) belongs, can impair the hearing, as observed by your son.
For the treatment of Pseudomonas, there are now alternatives available. Besides Tobramycin and Colistin, also Aztreonam and Levofloxacin are licensed for inhalation. The benefit of an inhalative therapy is porven by many studies. Therefore I recommend, to choose a suitable alternative together with his physicians in charge of the CF center. In addition, he should present at an ENT specialist in order to check the hearing.
Best regards,
Christian Hügel
26.10.2018