3 doctors weighed in:

Can inhaling Tobramycin kill MRSA ? I am a pedi trach patient. Will it kill Kleb Oxytoca that is ESBL?

3 doctors weighed in
Dr. Timothy Ashley
Internal Medicine & Pediatrics
1 doctor agrees

In brief: Tobi (tobramycin) Nebs

Inhaled tobi (tobramycin) is used mainly to reduce pseudomonas colonization in cf.
As noted, it is not active against gram positives like staph (mrsa or not). Kleb may be suceptible, but is not usually treated in this way. Kids with trachs grow a lot of organisms; agree that sorting out "infection" from "colonizer" is key. Both MRSA and kleb are often found in cultures but may not be the specific problem.

In brief: Tobi (tobramycin) Nebs

Inhaled tobi (tobramycin) is used mainly to reduce pseudomonas colonization in cf.
As noted, it is not active against gram positives like staph (mrsa or not). Kleb may be suceptible, but is not usually treated in this way. Kids with trachs grow a lot of organisms; agree that sorting out "infection" from "colonizer" is key. Both MRSA and kleb are often found in cultures but may not be the specific problem.
Dr. Timothy Ashley
Dr. Timothy Ashley
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1 comment
Dr. Timothy Ashley
The main evidence for tobi is in CF, but the principle probably applies to chronic trach patients. The landmark trial clearly showed that Ps. burden was lower with tobi in CF. Generally suspected infections, rather than colonization, require IV or oral therapy as the data are not yet strong, to my knowledge, for monotherapy with nebs.
Dr. Gregory Fehr
Emergency Medicine
1 doctor agrees

In brief: MRSA

Mrsa is resistant to tobramycin.
Klebsiella is not. Inhalation of antibiotics is not a regular medical practice, but is sounds like your child needs some "experimental" medical care. And it sounds like you child is propably getting the best.

In brief: MRSA

Mrsa is resistant to tobramycin.
Klebsiella is not. Inhalation of antibiotics is not a regular medical practice, but is sounds like your child needs some "experimental" medical care. And it sounds like you child is propably getting the best.
Dr. Gregory Fehr
Dr. Gregory Fehr
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1 comment
Dr. Timothy Ashley
Inhaled tobramycin is very much a regular, not experimental, medical practice and is standard of care at many institutions to reduce the burden of Pseudomonas and subsequent exacerbations in patients with cystic fibrosis.
Dr. Gregory Fehr
Emergency Medicine
1 doctor agrees

In brief: MRSA

Mrsa stands for methacillin resistant staphloccous aureaus.
This bacteria is most resistant to any antibiotic except vancomycin and teflor (not yet approved for pulmonary infections). Having MRSA may just mean your child is a carrier, not infected. Klebsiella is a totally different bacteria with different sensitivies, but also resistant to many antibiotics. An infectious disease specialist.

In brief: MRSA

Mrsa stands for methacillin resistant staphloccous aureaus.
This bacteria is most resistant to any antibiotic except vancomycin and teflor (not yet approved for pulmonary infections). Having MRSA may just mean your child is a carrier, not infected. Klebsiella is a totally different bacteria with different sensitivies, but also resistant to many antibiotics. An infectious disease specialist.
Dr. Gregory Fehr
Dr. Gregory Fehr
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