Inhaled tobramycin-associated hearing loss in an adolescent with renal failure

Tobramycin for inhalation is a mainstay of therapy for cystic fibrosis. Routine monitoring of serum concentrations is not performed for patients receiving tobramycin by this route. This is a case of an adolescent with cystic fibrosis, renal failure and a serum concentration of 13.4 mg/dL who was diagnosed with profound sensorineural hearing loss after 3 weeks of inhaled tobramycin therapy.