Maintenance tobramycin primarily affects untargeted bacteria in the CF sputum microbiome.

Rationale: The most common antibiotic used to treat people with cystic fibrosis (PWCF) is inhaled tobramycin, administered as maintenance therapy for chronic lung infections. While the effects of inhaled tobramycin on abundance and lung function diminish with continued therapy, this maintenance treatment is known to improve long-term outcomes, underscoring how little is known about why antibiotics work in CF infections, what their effects are on complex CF sputum microbiomes and how to improve these treatments.

Objectives: To rigorously define the effect of maintenance tobramycin on CF sputum microbiome characteristics.