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https://www.readbyqxmd.com/read/28509852/inhaled-antibiotic-therapy-in-chronic-respiratory-diseases
#1
REVIEW
Diego J Maselli, Holly Keyt, Marcos I Restrepo
The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF) and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, Burkholderia species and non-tuberculous Mycobacteria (NTM). These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics...
May 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28485320/aerosolized-amikacin-as-adjunctive-therapy-of-ventilator-associated-pneumonia-caused-by-multidrug-resistant-gram-negative-bacteria-a-single-center-randomized-controlled-trial
#2
Chang Liu, Yu-Ting Zhang, Zhi-Yong Peng, Qing Zhou, Bo Hu, Hui Zhou, Jian-Guo Li
BACKGROUND: Aerosolized amikacin (AA) is a current option for the management of ventilator-associated pneumonia (VAP) caused by multidrug-resistant Gram-negative bacteria (MDR-GNB), as it is reported that AA could increase the alveolar level of the drug without increasing systemic toxicity. This study aimed to evaluate the efficacy and safety of AA as an adjunctive therapy for VAP caused by MDR-GNB. METHODS: In this single-center, double-blind study conducted in a 36-bed general Intensive Care Unit (ICU) in a tertiary hospital from June 2014 to June 2016, 52 ICU patients with confirmed MDR-GNB VAP were randomized to two groups (AA group, n = 27 and placebo group, n = 25)...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28450200/aerosolized-tobramycin-for-pseudomonas-aeruginosa-ventilator-associated-pneumonia-in-patients-with-acute-respiratory-distress-syndrome
#3
Yohei Migiyama, Susumu Hirosako, Kentaro Tokunaga, Emi Migiyama, Takahiro Tashiro, Katsuyuki Sagishima, Hidenobu Kamohara, Yoshihiro Kinoshita, Hirotsugu Kohrogi
BACKGROUND: Ventilator-associated pneumonia (VAP) due to Pseudomonas aeruginosa has a high mortality and recurrence rate, especially in patients with acute respiratory distress syndrome (ARDS). Therefore, new therapeutic strategies against severe pneumonia are needed. This study evaluated the efficacy of aerosolized tobramycin for P. aeruginosa VAP in ARDS patients. METHODS: A retrospective analysis was performed on patients who developed VAP caused by P. aeruginosa during the course of ARDS at the intensive care unit (ICU) of Kumamoto University Hospital...
April 24, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28400338/recommendations-for-aerosolized-antibiotics-in-vap-and-vat-too-little-and-too-late
#4
EDITORIAL
Marin H Kollef, Scott T Micek
No abstract text is available yet for this article.
April 8, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28394614/a-synthetic-macromolecular-antibiotic-platform-for-inhalable-therapy-against-aerosolized-intracellular-alveolar-infections
#5
Debobrato Das, Jasmin Chen, Selvi Srinivasan, Abby Michelle Kelly, Brian Lee, Hye-Nam Son, Frank Radella, Timothy E West, Daniel M Ratner, Anthony J Convertine, Shawn J Skerrett, Patrick S Stayton
Lung-based intracellular bacterial infections remain one of the most challenging infectious disease settings. For example, the current standard for treating Franciscella tularensis pneumonia (tularemia) relies on prolonged administration of oral and intravenous antibiotics that poorly achieve and sustain pulmonary drug bioavailability. Inhalable antibiotic formulations are approved and in clinical development for upper respiratory infections, but sustained drug dosing from inhaled antibiotics against alveolar intracellular infections remains a current unmet need...
April 10, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28352199/survey-on-attitudes-of-italian-pediatricians-toward-cough
#6
Alessandro Zanasi, Luigi Morcaldi, Salvatore Cazzato, Massimiliano Mazzolini, Marzia Lecchi, Antonio Maria Morselli-Labate, Marianna Mastroroberto, Roberto W Dal Negro
CONTEXT: Children's cough is a daily concern for most pediatricians. The management of both acute and chronic cough requires a systematic and comprehensive approach. Despite the approved protocols for management, the pediatric assessment of cough and the corresponding prescribing attitude frequently do not fit these protocols, which can be affected by parental suggestions - sometimes substantially. OBJECTIVE: The objective of this study was to investigate both the perception and the behavior of a representative sample of Italian pediatricians toward cough in real life...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28347790/key-conceptional-considerations-on-nebulization-of-antimicrobial-agents-to-mechanically-ventilated-patients
#7
Jordi Rello, Jean Jacques Rouby, Candela Sole-Lleonart, Jean Chastre, Stijn Blot, Charles Edouard Luyt, Jordi Riera, Margreet C Vos, Antoine Monsel, Jayesh Dhanani, Jason A Roberts
Nebulized antibiotics have an established role in patients with cystic fibrosis or bronchiectasis. Their potential benefit to treat respiratory infections in mechanically ventilated patients is receiving increasing interest. In this Consensus Paper of the European Society of Clinical Microbiology and Infectious Diseases, the body of evidence of the therapeutic utility of aerosolized antibiotics in mechanically ventilated patients was reviewed and resulted in the following recommendations: A. Vibrating mesh nebulizers should be preferred to jet or ultrasonic nebulizers; B...
March 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28321572/the-extent-of-environmental-and-body-contamination-through-aerosols-by-hydro-surgical-debridement-in-the-lumbar-spine
#8
David Putzer, Ricarda Lechner, Debora Coraca-Huber, Astrid Mayr, Michael Nogler, Martin Thaler
INTRODUCTION: Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface. MATERIALS AND METHODS: On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28254026/the-fate-of-inhaled-antibiotics-after-deposition-in-cystic-fibrosis-how-to-get-drug-to-the-bug
#9
REVIEW
Aukje C Bos, Kimberly M Passé, Johan W Mouton, Hettie M Janssens, Harm A W M Tiddens
BACKGROUND: Chronic airway infections in patients with cystic fibrosis (CF) are most often treated with inhaled antibiotics of which deposition patterns have been extensively studied. However, the journey of aerosol particles does not end after deposition within the bronchial tree. OBJECTIVES: To review how local conditions affect the clinical efficacy of antibiotic aerosol particles after deposition in the airways of patients with CF. METHODS: Electronic databases were searched from inception to September 2015...
January 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28236797/community-acquired-pneumonia-caused-by-methicillin-resistant-staphylococcus-aureus-in-critically-ill-patients-systematic-review
#10
Nuria Carballo, Marta De Antonio-Cuscó, Daniel Echeverría-Esnal, Sonia Luque, Esther Salas, Santiago Grau
INTRODUCTION: Community-acquired pneumonia (CAP) is associated with high morbidity and mortality rates. Despite methicillin-resistant Staphylococcus aureus (MRSA) having often been associated with nosocomial pneumonia, the condition of some MRSA CAP patients is severe enough to warrant their being admitted to ICU. OBJECTIVE: The purpose of this study is to conduct a systematic review of the literature on antibiotic treatment of MRSA CAP in critically-ill patients...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28223382/in-vitro-and-in-vivo-activity-of-omadacycline-against-two-biothreat-pathogens-bacillus-anthracis-and-yersinia-pestis
#11
Judith Steenbergen, S Ken Tanaka, Lynda L Miller, Stephanie A Halasohoris, Jeremy R Hershfield
The in vitro activity and in vivo efficacy of omadacycline (OMC) were evaluated against the causative pathogens of anthrax and plague, Bacillus anthracis and Yersinia pestis, respectively. MICs of OMC were determined by broth microdilution according to CLSI guidelines for 30 isolates each of Y. pestis and B. anthracis The in vivo efficacy of omadacycline was studied at a range of dosages in both a postexposure prophylaxis (PEP) murine model of anthrax and plague as well as in a delayed treatment model of inhalational anthrax...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28187198/two-stable-variants-of-burkholderia-pseudomallei-strain-mshr5848-express-broadly-divergent-in-vitro-phenotypes-associated-with-their-virulence-differences
#12
A A Shea, R C Bernhards, C K Cote, C J Chase, J W Koehler, C P Klimko, J T Ladner, D A Rozak, M J Wolcott, D P Fetterer, S J Kern, G I Koroleva, S P Lovett, G F Palacios, R G Toothman, J A Bozue, P L Worsham, S L Welkos
Burkholderia pseudomallei (Bp), the agent of melioidosis, causes disease ranging from acute and rapidly fatal to protracted and chronic. Bp is highly infectious by aerosol, can cause severe disease with nonspecific symptoms, and is naturally resistant to multiple antibiotics. However, no vaccine exists. Unlike many Bp strains, which exhibit random variability in traits such as colony morphology, Bp strain MSHR5848 exhibited two distinct and relatively stable colony morphologies on sheep blood agar plates: a smooth, glossy, pale yellow colony and a flat, rough, white colony...
2017: PloS One
https://www.readbyqxmd.com/read/28184305/once-daily-aerosolised-tobramycin-in-adult-patients-with-cystic-fibrosis-in-the-management-of-pseudomonas-aeruginosa-chronic-infection
#13
Marco Mantero, Andrea Gramegna, Giovanna Pizzamiglio, Alice D'Adda, Paolo Tarsia, Francesco Blasi
It is estimated that about 60-70% of Cystic Fibrosis patients develop Pseudomonas aeruginosa chronic infection, with progressive loss of lung function, as well as increased antibiotic resistance and mortality. The current strategy is to maintain lung function by chronic suppressive antipseudomonas antibiotic therapy. Tobramycin inhalation solution was the first approved aerosolised antibiotic to be used against P. aeruginosa; inhalatory tobramycin frequency of administration is twice daily and inhalation time is estimated to be 15 to 20 min...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28177960/innate-immune-response-to-burkholderia-mallei
#14
Kamal U Saikh, Tiffany M Mott
PURPOSE OF REVIEW: Burkholderia mallei is a facultative intracellular pathogen that causes the highly contagious and often the fatal disease, glanders. With its high rate of infectivity via aerosol and recalcitrance toward antibiotics, this pathogen is considered a potential biological threat agent. This review focuses on the most recent literature highlighting host innate immune response to B. mallei. RECENT FINDINGS: Recent studies focused on elucidating host innate immune responses to the novel mechanisms and virulence factors employed by B...
June 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28166240/involvement-of-multiple-stressors-induced-by-non-thermal-plasma-charged-aerosols-during-inactivation-of-airborne-bacteria
#15
Nachiket D Vaze, Sin Park, Ari D Brooks, Alexander Fridman, Suresh G Joshi
A lab-scale, tunable, single-filament, point-to-point nonthermal dieletric-barrier discharge (DBD) plasma device was built to study the mechanisms of inactivation of aerosolized bacterial pathogens. The system inactivates airborne antibiotic-resistant pathogens efficiently. Nebulization mediated pre-optimized (4 log and 7 log) bacterial loads were challenged to plasma-charged aerosols, and lethal and sublethal doses determined using colony assay, and cell viability assay; and the loss of membrane potential and cellular respiration were determined using cell membrane potential assay and XTT assay...
2017: PloS One
https://www.readbyqxmd.com/read/28163231/effects-of-storage-conditions-on-the-stability-of-spray-dried-inhalable-bacteriophage-powders
#16
Sharon S Y Leung, Thaigarajan Parumasivam, Fiona G Gao, Elizabeth A Carter, Nicholas B Carrigy, Reinhard Vehring, Warren H Finlay, Sandra Morales, Warwick J Britton, Elizabeth Kutter, Hak-Kim Chan
This study aimed to develop inhalable powders containing phages active against antibiotic-resistant Pseudomonas aeruginosa for pulmonary delivery. A Pseudomonas phage, PEV2, was spray dried into powder matrices comprising of trehalose (0-80%), mannitol (0-80%) and l-leucine (20%). The resulting powders were stored at various relative humidity (RH) conditions (0, 22 and 60% RH) at 4°C. The phage stability and in vitro aerosol performance of the phage powders were examined at the time of production and after 1, 3 and 12 months storage...
April 15, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28160023/the-intensive-care-medicine-research-agenda-on-multidrug-resistant-bacteria-antibiotics-and-stewardship
#17
REVIEW
Marin H Kollef, Matteo Bassetti, Bruno Francois, Jason Burnham, George Dimopoulos, Jose Garnacho-Montero, Jeffrey Lipman, Charles-Edouard Luyt, David P Nicolau, Maarten J Postma, Antonio Torres, Tobias Welte, Richard G Wunderink
PURPOSE: To concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to the management of multidrug-resistant (MDR) bacteria, antibiotic use, and antimicrobial stewardship in the intensive care unit (ICU) setting. METHODS: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion...
February 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28159177/microbiology-and-epidemiology-of-legionnaire-s-disease
#18
REVIEW
Almudena Burillo, María Luisa Pedro-Botet, Emilio Bouza
Legionnaire's disease (LD) is the pneumonic form of legionellosis caused by aerobic gram-negative bacilli of the genus Legionella. Individuals become infected when they inhale aerosolized water droplets contaminated with Legionella species. Forty years after the identification of Legionella pneumophila as the cause of the 1976 pneumonia outbreak in a hotel in Philadelphia, we have non-culture-based diagnostic tests, effective antibiotics, and preventive measures to handle LD. With a mortality rate still around 10%, underreporting, and sporadic outbreaks, there is still much work to be done...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/27916621/point-should-inhaled-antibiotic-therapy-be-used-routinely-for-the-treatment-of-bacterial-lower-respiratory-tract-infections-in-the-icu-setting-yes
#19
EDITORIAL
https://www.readbyqxmd.com/read/27890714/a-randomized-trial-of-the-amikacin-fosfomycin-inhalation-system-for-the-adjunctive-therapy-of-gram-negative-ventilator-associated-pneumonia-iasis-trial
#20
Marin H Kollef, Jean-Damien Ricard, Damien Roux, Bruno Francois, Eleni Ischaki, Zsolt Rozgonyi, Thierry Boulain, Zsolt Ivanyi, Gál János, Denis Garot, Firas Koura, Epaminondas Zakynthinos, George Dimopoulos, Antonio Torres, Wayne Danker, A Bruce Montgomery
BACKGROUND: Clinical failures in ventilator-associated pneumonia (VAP) caused by Gram-negative bacteria are common and associated with substantial morbidity, mortality, and resource utilization. METHODS: We assessed the safety and efficacy of the amikacin fosfomycin inhalation system (AFIS) for the treatment of Gram-negative bacterial VAP in a randomized double-blind, placebo-controlled, parallel group, phase 2 study between May 2013 and March 2016. We compared standard of care in each arm plus 300 mg amikacin/120 mg fosfomycin or placebo (saline), delivered by aerosol twice daily for 10 days (or to extubation if <10 days) via the investigational eFlow Inline System (PARI GmbH, Germany)...
November 24, 2016: Chest
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