Intervention: Tobramycin
Trial phase: Phase 3
ATC code: J01GB01 | S01AA12
SMILES: NC[C@H]1O[C@H](O[C@H]2[C@H](O)[C@@H](O[C@H]3O[C@H](CO)[C@@H](O)[C@H](N)[C@H]3O)[C@H](N)C[C@@H]2N)[C@H](N)C[C@@H]1O
Sex: All
Age groups: Child | Adult
Healthy volunteers: No
Participants at risk: 30
Group description: Tobramycin 28 mg powder. The TIP dose of 112 mg twice a day (bis in diem = b.i.d.), given in a cycle of 28 days on treatment followed by 28 days off treatment.
Eligibility criteria:
Inclusion Criteria:

Written informed consent given by adults or by the parents/legal guardian in combination with the patient's assent, if capable of assenting, before any assessment was performed

Confirmed diagnosis of Cystic Fibrosis (CF) by the presence of one or more clinical features of CF in addition to:

a quantitative pilocarpine iontophoresis sweat chloride test of >60 mEq/L; or
identification of well-characterized disease-causing mutations in each CFTR gene; or
an abnormal nasal transepithelial potential difference characteristic of CF.
Forced Expiratory Volume in one second (FEV1) at screening must have been ≥25% and ≤80% of normal predicted values for age, sex, and height based on Knudson criteria
P. aeruginosa must have been present in a sputum/deep-throat cough swab culture (or bronchoalveolar lavage [BAL]) within 6 months prior to screening and in the sputum/deep-throat cough swab culture at the screening visit
Able to expectorate a sputum sample or provide a deep throat cough swab at screening
Able to comply with all protocol requirements
Use of an effective means of contraception in females of childbearing potential
Clinically stable in the opinion of the investigator to be treated according to this protocol

Exclusion Criteria:

FEV1 at baseline (Visit 2) <25% or >80% of normal predicted values for age, sex, and height based on Knudson criteria, and/or FEV1 at baseline (Visit 2) deviated by ≥10% from the FEV1 measured at screening (Visit 1)
Any use of inhaled anti-pseudomonal antibiotics within 4 months prior to screening
Any use of systemic anti-pseudomonal antibiotics within 28 days prior to study drug administration
Serum creatinine 2 mg/dL or above, blood urea nitrogen (BUN) 40 mg/dL or above, or an abnormal urinalysis defined as 2+ or greater proteinuria
Known local or systemic hypersensitivity to aminoglycosides or inhaled antibiotics
Signs and symptoms of acute pulmonary disease, e.g. pneumonia, pneumothorax
Administration of any investigational drug within 30 days prior to enrollment
Any previous exposure to tobramycin dry powder for inhalation (TIP)
Administration of loop diuretics within 7 days prior to study drug administration
Initiation of treatment with chronic macrolide therapy within 28 days prior to study drug administration
Initiation of treatment with dornase alfa within 28 days prior to study drug administration
Initiation of treatment with inhaled steroids (or increased dose) within 28 days prior to study drug administration
Initiation of treatment with inhaled hypertonic saline (HS) within 28 days prior to study drug administration
Personal history of abnormal hearing or family history of abnormal hearing other than typical hearing loss associated with the aging process
Known abnormal result from any audiology testing (defined as either a unilateral puretone audiometry test showing a threshold elevation >20 dB at any frequency across the frequency range 0.25 kHz to 8 kHz or the absence of emission at the evoked otoacoustic emission test)
History of sputum culture or throat swab (or BAL) culture yielding Burkholderia cepacia (B. cepacia) within 2 years prior to screening and/or sputum culture yielding B. cepacia at screening
Hemoptysis of more than 60 mL at any time within 30 days prior to study drug administration
History of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years, regardless of evidence of local recurrence or metastases
Patients with clinically significant laboratory abnormalities (not associated with the study indication) at screening
Patients or caregivers with a history of noncompliance to medical regimens and patients or caregivers who are considered potentially unreliable
Pregnant or nursing (lactating) women
Women of child-bearing potential unless they used two reliable birth control methods

Other protocol-defined inclusion/exclusion criteria may apply