scholarly journals Risk of Development of Resistance in Patients with Non-Cystic Fibrosis Bronchiectasis Treated with Inhaled Antibiotics

2018 ◽  
Vol 7 (3) ◽  
pp. 63-71 ◽  
Author(s):  
Kate H. Regan ◽  
Adam T. Hill
Keyword(s):  
Cystic Fibrosis ◽  
Development Of Resistance ◽  
Inhaled Antibiotics

scholarly journals Once Daily Dosing of Aminoglycosides in Pediatric Cystic Fibrosis Patients: A Review of the Literature

2008 ◽  
Vol 13 (2) ◽  
pp. 68-75
Author(s):  
Sarah K. Wassil ◽  
Kristie M. Fox ◽  
James W. White
Keyword(s):  
Cystic Fibrosis ◽  
Review Of The Literature ◽  
Nursing Time ◽  
Once Daily ◽  
Development Of Resistance ◽  
Cystic Fibrosis Population ◽  
Antibiotic Effect ◽  
Home Administration ◽  
Post Antibiotic Effect

Patients with cystic fibrosis receive many courses of antibiotic therapy throughout their lifetime. Dosing aminoglycosides once daily has become common practice in many of these individuals. Due to ease of home administration, decreased nursing time, and improved quality of life, this regimen is being increasingly explored in the cystic fibrosis population. Because patients with cystic fibrosis have increased aminoglycoside clearance, once daily dosing may result in a prolonged time during the dosing interval when concentrations of the drug may be undetectable. This makes the use of once daily dosing of these antibiotics in patients with cystic fibrosis controversial. Although aminoglycosides exhibit a post antibiotic effect, the duration of this effect is unknown in humans; therefore, the development of resistance to the aminoglycoside is a concern. This manuscript will review the organisms most commonly associated with a pulmonary exacerbation of cystic fibrosis, the properties of the aminoglycoside that make once daily dosing feasible, the concept of once daily dosing in those with cystic fibrosis and the current literature regarding efficacy, monitoring, toxicity and concerns of resistance with once daily dosing in this population.

Case 13

2020 ◽  
pp. 81-86
Author(s):  
Hilary Humphreys
Keyword(s):  
Cystic Fibrosis ◽  
Stenotrophomonas Maltophilia ◽  
New Technologies ◽  
Microbiology Laboratory ◽  
Oral Antibiotics ◽  
Flight Mass Spectrometry ◽  
Single Room ◽  
Inhaled Antibiotics ◽  
True Infection ◽  
Opportunist Pathogen

There is an increasing number of opportunist pathogens that may cause acute pulmonary exacerbations of cystic fibrosis as the patient cohort survives longer. However, it can often be difficult to determine if the isolation of these bacteria represents colonization or true infection. Their identification from sputum samples in the microbiology laboratory is also challenging, requires significant scientific expertise, and is assisted by new technologies such as MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). One such opportunist pathogen is Stenotrophomonas maltophilia, for which risk factors include increasing age and recent oral antibiotics, especially carbapenems. However, it is unclear if this bacterium is transmitted from patient to patient unlike with Pseudomonas aeruginosa, but all patients with cystic fibrosis should be admitted to a single room when hospitalization is required. Controversies exist regarding the optimal treatment which in the future may include a greater reliance on inhaled antibiotics.

scholarly journals Microbiological contamination of nebulizers used by cystic fibrosis patients: an underestimated problem

2019 ◽  
Vol 45 (3) ◽  
Author(s):  
Barbara Riquena ◽  
Luciana de Freitas Velloso Monte ◽  
Agnaldo José Lopes ◽  
Luiz Vicente Ribeiro Ferreira da Silva-Filho ◽  
Neiva Damaceno ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Burkholderia Cepacia ◽  
Tap Water ◽  
Significant Proportion ◽  
Burkholderia Cepacia Complex ◽  
Structured Interviews ◽  
Candida Spp ◽  
Cross Sectional ◽  
Inhaled Antibiotics ◽  
Cleaning And Disinfection

ABSTRACT Objective: Home nebulizers are routinely used in the treatment of patients with cystic fibrosis (CF). This study aims to evaluate the contamination of nebulizers used for CF patients, that are chronically colonized by Pseudomonas aeruginosa, and the association of nebulizer contamination with cleaning, decontamination and drying practices. Methods: A cross-sectional, observational, multicenter study was conducted in seven CF reference centers in Brazil to obtain data from medical records, structured interviews with patients/caregivers were performed, and nebulizer’s parts (interface and cup) were collected for microbiological culture. Results: overall, 77 CF patients were included. The frequency of nebulizer contamination was 71.6%. Candida spp. (52.9%), Stenotrophomonas maltophilia (11.9%), non-mucoid P. aeruginosa (4.8%), Staphylococcus aureus (4.8%) and Burkholderia cepacia complex (2.4%) were the most common isolated pathogens. The frequency of nebulizers’ hygiene was 97.4%, and 70.3% of patients reported cleaning, disinfection and drying the nebulizers. The use of tap water in cleaning method and outdoor drying of the parts significantly increased (9.10 times) the chance of nebulizers’ contamination. Conclusion: Despite the high frequency hygiene of the nebulizers reported, the cleaning and disinfection methods used were often inadequate. A significant proportion of nebulizers was contaminated with potentially pathogenic microorganisms for CF patients. These findings support the need to include patients/caregivers in educational programs and / or new strategies for delivering inhaled antibiotics.

Efficacy and safety of inhaled antibiotics for chronicpseudomonasinfection in cystic fibrosis: Network meta-analysis

2016 ◽  
Author(s):  
Stuart Elborn ◽  
Anne-Lise Vataire ◽  
Ayako Fukushima ◽  
Samuel Aballéa ◽  
Amine Khemiri ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Inhaled Antibiotics

scholarly journals Tobramycin Inhalation Powder (TIP): An Efficient Treatment Strategy for the Management of Chronic Pseudomonas Aeruginosa Infection in Cystic Fibrosis

2013 ◽  
Vol 7 ◽  
pp. CCRPM.S10592 ◽  
Author(s):  
John Lam ◽  
Steven Vaughan ◽  
Michael D. Parkins
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Treatment Strategy ◽  
Standard Of Care ◽  
Efficient Treatment ◽  
Adaptive Resistance ◽  
Inhaled Antibiotics ◽  
Pseudomonas Aeruginosa Infection ◽  
High Concentrations ◽  
Inhalation Powder

Repeated bouts of acute and chronic lung infections are responsible for progressive pulmonary function decline in individuals with cystic fibrosis (CF), ultimately leading to respiratory failure and death. Pseudomonas aeruginosa is the archetypical CF pathogen, causes chronic infection in 70% of individuals, and is associated with an accelerated clinical decline. The management of P. aeruginosa in CF has been revolutionized with the development and widespread use of inhaled antibiotics. Aerosol delivery of antimicrobial compounds in CF enables extremely high concentrations of antibiotics to be reached directly at the site of infection potentially overcoming adaptive resistance and avoiding the potential for cumulative systemic toxicities. Tobramycin inhalation powder (TIP) represents the first dry powder inhaled (DPI) antibiotic available for use in CF. DPIs are notable for a markedly reduced time for administration, ease of portability, and increased compliance. TIP has been developed as a therapeutic alternative to tobramycin inhalation solution (TIS), the standard of care for the past 20 years within CF. Relative to TIS 300 mg nebulized twice daily in on-and-off cycles of 28 days duration, TIP 112 mg twice daily via the T-326 inhaler administered on the same schedule is associated with marked time savings, increased patient satisfaction, and comparable clinical end points. TIP represents an innovative treatment strategy for those individuals with CF and holds the promise of increased patient compliance and thus the potential for improved clinical outcomes.

Candida albicanschronic colonisation in cystic fibrosis may be associated with inhaled antibiotics

Mycoses ◽  
2015 ◽  
Vol 58 (7) ◽  
pp. 416-421 ◽  
Author(s):  
Maria Noni ◽  
Anna Katelari ◽  
Athanasios Kaditis ◽  
Ioanna Theochari ◽  
Ioulia Lympari ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Inhaled Antibiotics

scholarly journals 117 The fate of inhaled antibiotics after deposition in patients with cystic fibrosis: how to get drug to the bug?

2016 ◽  
Vol 15 ◽  
pp. S80-S81 ◽  
Author(s):  
A.C. Bos ◽  
K.M. Passé ◽  
J.W. Mouton ◽  
H.M. Janssens ◽  
H.A.W.M. Tiddens
Keyword(s):  
Cystic Fibrosis ◽  
Inhaled Antibiotics

scholarly journals 92 Early treatment with inhaled antibiotics postpones recurrence of Achromobacter species in cystic fibrosis

2013 ◽  
Vol 12 ◽  
pp. S72
Author(s):  
M. Wang ◽  
W. Ridderberg ◽  
C.R. Hansen ◽  
N. Høiby ◽  
S. Jensen-Fangel ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Early Treatment ◽  
Inhaled Antibiotics
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