The Drug-Induced Respiratory Disease Website

Tobramycin (nebulized, inhaled)

Bronchospasm - Wheezing - Asthma

Reported in cyctic fibrosis patients

Nikolaizik WH, Trociewicz K, Ratjen F

Bronchial reactions to the inhalation of high-dose tobramycin in cystic fibrosis.

The European respiratory journal 2002 Jul;20;122-6 — 2002 Jul — 122-6

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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