Nebulized tobramycin: prevention of pneumonias in patients with severe cerebral palsy.

BACKGROUND AND METHODS: In patients with severe cerebral palsy, pneumonias are a frequent occurrence and can lead to excessive morbidity and mortality. Similar poor outcomes can occur in patients with cystic fibrosis. Nebulized tobramycin has been shown to be effective in preventing pneumonias, and in improving lung function in cystic fibrosis patients. This study reports results from three patients with severe cerebral palsy who were suffering from recurrent pneumonias. We compared the 12 months prior to starting nebulized tobramycin, to the first 12 months of intermittent therapy (28 days of nebulized antibiotic, followed by 28 days with no antibiotic, then repeated). We noted the number of pneumonias, the number of hospitalizations due to pneumonia, and length of hospitalizations for pneumonia.
RESULTS: Adding the results from the three patients together, the number of pneumonias went from 19 during the year prior to starting the nebulized tobramycin, to 11 during the year of treatment. The number of hospitalizations for pneumonia went from 11 to 0. The number of days in hospital for pneumonia went from 110 to 0.
CONCLUSION: As in cystic fibrosis patients, patients with severe cerebral palsy may benefit from the intermittent use of nebulized tobramycin to prevent pneumonias and hospitalizations due to pneumonia. Further studies are warranted.