NICE recommends tobramycin and colistimethate sodium dry powders for inhalation as possible treatments for chronic pseudomonas lung infection in some people with cystic fibrosis (see below).
Who can have colistimethate sodium and tobramycin dry powders for inhalation?
You should be able to have tobramycin dry powder for inhalation if nebulised tobramycin is an appropriate treatment for you because colistimethate sodium is not suitable for you or hasn't worked well enough.
You should be offered colistimethate dry powder for inhalation if you would benefit from continued colistimethate sodium treatment but cannot take it in its nebulised form and you would otherwise be offered tobramycin treatment.
Why has NICE said this?
NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS. NICE recommended colistimethate sodium dry powder for inhalation because it offers an alternative mode of delivery of colistimethate sodium for people who could benefit from colistimethate sodium but can't tolerate it in a nebulised form and would otherwise use tobramycin therapy (a more expensive treatment). NICE recommended tobramycin dry powder for inhalation when colistimethate sodium treatment isn't suitable because it works as well as nebulised tobramycin and it may be preferred by some patients.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.