Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient

Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient

Objectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization. Methods: A...

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Main Authors: Shin Tanaka, Tuyoshi Ryuko, Yasuaki Tomioka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Hideharu Hagiya, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:International Journal of Infectious Diseases
Subjects:
Inhaled tobramycin
Lung transplantation
Pseudomonas aeruginosa
Recurrent diffuse panbronchiolitis
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225001365
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Summary:Objectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization. Methods: A Japanese woman with a history of DPB experienced disease recurrence following bilateral LTx. Persistent colonization by P. aeruginosa and recurrent respiratory symptoms were observed. Off-label TSI therapy, commonly used in cystic fibrosis, was introduced. Clinical response was assessed through radiologic imaging, bronchoscopy, and microbiological cultures. Results: TSI administration led to significant clinical and radiological improvement. P. aeruginosa was eradicated from sputum cultures within one month and remained absent throughout six months of follow-up. No hospitalizations or adverse events were reported during therapy. Conclusion: This case suggests the potential of TSI as a therapeutic approach for managing recurrent DPB and indicates its role in stabilizing post-transplant outcomes. Further studies may clarify its efficacy and expand its application in broader DPB management strategies.
ISSN:1201-9712

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