well, #1, PARI Trek does not create small enough particles for TOBI to be of a respirable dose. so you're wasting your time trying to give TOBI on a PARI Trek... your kid is probably getting 1/5 of the dose that he/she should be getting.
Getting a smaller dose of an antibiotic leads to resistance. Last thing you want with PA is resistance... there is already a small # of antibiotics that PA is suseptable to. Resistance to Tobramycin and aminoglycocides is not someting you want.
I would suggest a PARI ProNeb Ultra for TOBI.
If you want to get a quick approval from Medicaid, tell them that the device you have doesn't create a respirable dose of TOBI. Studies show that the use of TOBI leads to fewer hospitalizations. It would be in Medicaid's best interest to keep your kid out of the hospital because it's costly ($10's of 1,000 of $) whereas a PARI ProNeb Ultra is around $100.
<b>Smack your doctor across the head for writing you a prescription for a compressor that cannot be used with TOBI. That type of ignorance is unacceptable for the care of you 6 month old! He should know better. </b>