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Antibiotic nebulised

Matthew S Dryden, Jonathan Cooke, Rami J Salib, Rebecca E Holding, Timothy Biggs, Ali A Salamat, Raymond N Allan, Rachel S Newby, Fenella Halstead, Beryl Oppenheim, Thomas Hall, Sophie C Cox, Liam M Grover, Zain Al-Hindi, Lilyann Novak-Frazer, Malcolm D Richardson
Reactive oxygen species (ROS) is a novel therapeutic strategy for topical or local application to wounds, mucosa or internal structures where there may be heavy bacterial bioburden with biofilm and chronic inflammation. Bacterial biofilms are a significant problem in clinical settings owing to their increased tolerance towards conventionally prescribed antibiotics and their propensity for selection of further antibacterial resistance. There is therefore a pressing need for the development of alternative therapeutic strategies that can improve antibiotic efficacy towards biofilms...
February 14, 2017: Journal of Global Antimicrobial Resistance
Hirminder Ubhi, Mitul Patel, Lisa Ludwig
AIM: Aims of the study included evaluation of outpatient antibiotic prescribing practices relating to good Antimicrobial Stewardship1 focusing on documentation of indication and duration. METHOD: Prescriptions dispensed at the Outpatient Pharmacy over a 6 week were evaluated. Data collected include patient's hospital identification in full, the antibiotic prescribed, duration of treatment, indication (in a specifically allocated area on the prescription) and route of administration, prescriber speciality and grade...
September 2016: Archives of Disease in Childhood
Tracey Remmington, Nikki Jahnke, Christian Harkensee
BACKGROUND: Pseudomonas aeruginosa is the most common bacterial pathogen causing lung infections in people with cystic fibrosis and appropriate antibiotic therapy is vital. Antibiotics for pulmonary exacerbations are usually given intravenously, and for long-term treatment, via a nebuliser. Oral anti-pseudomonal antibiotics with the same efficacy and safety as intravenous or nebulised antibiotics would benefit people with cystic fibrosis due to ease of treatment and avoidance of hospitalisation...
July 14, 2016: Cochrane Database of Systematic Reviews
H J Zar, S A Madhi, D A White, R Masekela, S Risenga, H Lewis, C Feldman, B Morrow, P Jeena
Management of acute viral bronchiolitis is largely supportive. There is currently no proven effective therapy other than oxygen for hypoxic children. The evidence indicates that there is no routine benefit from inhaled, rapid short-acting bronchodilators, adrenaline or ipratropium bromide for children with acute viral bronchiolitis. Likewise, there is no demonstrated benefit from routine use of inhaled or oral corticosteroids, inhaled hypertonic saline nebulisation, montelukast or antibiotics. The last should be reserved for children with severe disease, when bacterial co-infection is suspected...
April 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Şule Cömert, Esen Kıyan, Gülfer Okumuş, Orhan Arseven, Turhan Ece, Halim İşsever
INTRODUCTION: Conflicting results has been achieved in a small number of clinical studies evaluating the efficiency of magnesium sulphate (MS) in COPD exacerbations. We aimed to investigate the efficiency of nebulised MS in COPD exacerbations. PATIENTS AND METHODS: Twenty patients who met the study criteria were randomized into two groups. All patients were treated with O2, antibiotics and oral corticosteroids. Additionally one group received ipratropium bromide (IB) 500 µg together with MS 151 mg/dose, while the other group received IB together with placebo...
March 2016: Tüberküloz Ve Toraks
G King, A Byrne, P Fleming
BACKGROUND: An allergic reaction following a dental procedure is a rare event. A local anaesthetic (LA) may initially be suspected as a causative agent but allergy to dental LA solutions is extremely rare. CASE REPORT: This report concerns a 13 year old child who underwent dental treatment and was exposed to Lignospan Special(®) LA, mouthwash, latex gloves, ibuprofen medication, and a Magnum(®) (almond) ice cream all within 45 min. He subsequently developed acute symptoms of nasal rhinorrhoea, facial flushing, peri-orbital and lip angioedema, followed by throat tightness and wheeze (respiratory compromise)...
August 2016: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
Sanjay Sethi, Jenny Bryan
European Respiratory Society Congress, Amsterdam, 26-30 September 2015, and CHEST 2015, Montréal, Canada, 24-28 October 2015 With approximately 50,000 deaths in the US and EU attributed to antibacterial resistance each year, together with several million days of hospital care [1], the need to address resistance mechanisms and find new targets for novel antibiotics has never been greater. At the annual congresses of the European Respiratory Society and the American College of Chest Physicians, presenters reported advances in understanding of the mechanisms of antibiotic resistance and how these may be overcome...
2016: Future Microbiology
Nikhita Ange, David J Rabbolini, Michael Pidcock, Katrina L Randall
A man in his 60s was brought to the emergency department, with airway compromise and dysarthria due to a grossly enlarged tongue. As he was on a current course of antibiotics, he was treated for a likely antibiotic-associated allergic reaction. However, as he failed to improve with intramuscular and nebulised epinephrine, another cause of his symptoms was sought. Further discussion revealed a history of chronic lymphocytic leukaemia (CLL), which had recently relapsed. Investigations were ordered to confirm that the symptoms were due to acquired angioedema, and the patient was managed for this diagnosis based on the presence of an undetectable C4 level...
January 28, 2016: BMJ Case Reports
Karen Mooney, Cristín Ryan, Damian G Downey
BACKGROUND: Cystic Fibrosis (CF) management requires complex treatment regimens but adherence to treatment is poor and has negative health implications. There are various methods of measuring adherence, but little is known regarding the extent of adherence measurement in CF centres throughout the UK and Ireland. OBJECTIVE: To determine the adherence monitoring practices in CF centres throughout the UK and Ireland, and to establish CF pharmacists' views on these practices...
April 2016: International Journal of Clinical Pharmacy
Amparo Solé, Rosa Ma Girón
Nebulized antibiotic therapy is an attractive therapeutic option given the high concentration obtained from the drug at the site of infection, minimizing the adverse effects and possible drug interactions. Inhalation of drugs as treatment of cystic fibrosis (CF) related lung disease has been proven to be highly effective. Consequently, an increasing number of drugs and devices have been developed for CF lung disease or are currently under development. Other limited areas of experience in this field are lung transplant recipients, immunosuppressed patients, bronchiectasis and ventilated patients...
September 2015: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Ramon Orriols, Rosana Hernando, Adelaida Ferrer, Sonia Terradas, Bruno Montoro
BACKGROUND: No prospective study has assessed eradication treatment of early Pseudomonas aeruginosa colonisation in bronchiectasis not due to cystic fibrosis (CF). OBJECTIVES: To evaluate the efficacy of 3 months of nebulised tobramycin after a short course of intravenous antibiotics in the eradication of P. aeruginosa and its clinical consequences in non- CF bronchiectasis following initial P. aeruginosa infection. METHODS: A 15-month, single-masked, randomised study including 35 patients was conducted in a tertiary university hospital...
2015: Respiration; International Review of Thoracic Diseases
Penny Agent, Helen Parrott
KEY POINTS: There have been significant advances in both inhalation medicines and delivery devices with "intelligent nebulisers" and "dry-powder inhalers" becoming commonplace in CF care.Inhaled medicines generate high levels of a drug within the airways with limited systemic effects, offering safe and convenient antibiotic and mucolytic therapy for individuals with CF.Variations in adherence are not unique to CF; however, treatment burden is high and therefore fast inhaled drug delivery devices may assist individuals in completing the prescribed treatment regimes...
June 2015: Breathe
Matthew N Hurley, Andrew P Prayle, Patrick Flume
BACKGROUND: Cystic fibrosis is a multi-system disease characterised by the production of thick secretions causing recurrent pulmonary infection, often with unusual bacteria. Intravenous antibiotics are commonly used in the treatment of acute deteriorations in symptoms (pulmonary exacerbations); however, recently the assumption that exacerbations are due to increases in bacterial burden has been questioned. OBJECTIVES: To establish if intravenous antibiotics for the treatment of pulmonary exacerbations in people with cystic fibrosis improve short- and long-term clinical outcomes...
2015: Cochrane Database of Systematic Reviews
Emma J Welsh, David J Evans, Stephen J Fowler, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal dilatation of the bronchi, and presents typically with a chronic productive cough (or chronic wet cough in children) and recurrent infective exacerbations. It significantly impacts daily activities and quality of life, and can lead to recurrent hospitalisations, severe lung function impairment, respiratory failure and even death. OBJECTIVES: To provide an overview of the efficacy and safety of interventions for adults and children with bronchiectasis from Cochrane reviews...
July 14, 2015: Cochrane Database of Systematic Reviews
Peter J Barry, Andrew M Jones
Recently, a significant number of additional key medications have become licensed in Europe for the treatment of patients with cystic fibrosis (CF), including a number of inhaled antibiotics, such as nebulised aztreonam and dry powder versions of colistin and tobramycin for inhalation; dry powder inhaled mannitol, an agent to improve airway hydration and aid airway clearance; and ivacaftor, an oral therapy that directly acts on dysfunctional CFTR to correct the basic defect encountered in CF patients with the G551D CF gene mutation...
July 2015: Drugs
S L Kenny, T D Shaw, D G Downey, J E Moore, J C Rendall, J S Elborn
BACKGROUND: Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8-93.0%. In this retrospective cohort study, we report the outcomes of AET in an adult population. METHODS: Adults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012...
2014: BMJ Open Respiratory Research
Katharine Hurt, Diana Bilton
Treatment of cystic fibrosis lung disease has developed from an understanding of the abnormal airway surface liquid resulting from a lack of function of the cystic fibrosis transmembrane regulator protein. Mucus plugging resulting in infection and inflammation leads to airway wall destruction and bronchiectasis. Inhaled therapies have formed the backbone of treatments. In combination with antibiotics delivered direct to the airway, mucoactive drugs, including mucolytics and hyperosmolar agents, are utilised to improve mucociliary clearance to reduce infection and inflammation...
2014: Respiration; International Review of Thoracic Diseases
Roger L Nation, Jian Li, Otto Cars, William Couet, Michael N Dudley, Keith S Kaye, Johan W Mouton, David L Paterson, Vincent H Tam, Ursula Theuretzbacher, Brian T Tsuji, John D Turnidge
In the face of diminishing therapeutic options for the treatment of infections caused by multidrug-resistant, Gram-negative bacteria, clinicians are increasingly using colistin and polymyxin B. These antibiotics became available clinically in the 1950s, when understanding of antimicrobial pharmacology and regulatory requirements for approval of drugs was substantially less than today. At the 1st International Conference on Polymyxins in Prato, Italy, 2013, participants discussed a set of key objectives that were developed to explore the factors affecting the safe and effective use of polymyxins, identify the gaps in knowledge, and set priorities for future research...
February 2015: Lancet Infectious Diseases
Anne C Ballin, Bianka Schulz, Christopher Helps, Carola Sauter-Louis, Ralf S Mueller, Katrin Hartmann
Despite a lack of controlled studies confirming its efficacy, recombinant feline interferon-omega (rfeIFN-ω) is used in the treatment of feline upper respiratory tract disease (FURTD), which is usually caused by feline calicivirus (FCV) or feline herpesvirus-1 (FHV-1). The aims of the present study were to investigate whether administration of rfeIFN-ω improves clinical signs in cats with acute FURTD and whether this treatment reduces shedding of FCV. Thirty-seven cats affected with acute FURTD were recruited into a prospective, randomised, placebo-controlled, double-blinded clinical trial...
December 2014: Veterinary Journal
Qi Tony Zhou, Sharon Shui Yee Leung, Patricia Tang, Thaigarajan Parumasivam, Zhi Hui Loh, Hak-Kim Chan
Respiratory infections represent a major global health problem. They are often treated by parenteral administrations of antimicrobials. Unfortunately, systemic therapies of high-dose antimicrobials can lead to severe adverse effects and this calls for a need to develop inhaled formulations that enable targeted drug delivery to the airways with minimal systemic drug exposure. Recent technological advances facilitate the development of inhaled anti-microbial therapies. The newer mesh nebulisers have achieved minimal drug residue, higher aerosolisation efficiencies and rapid administration compared to traditional jet nebulisers...
May 2015: Advanced Drug Delivery Reviews
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