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Inhaled tobramycin

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https://www.readbyqxmd.com/read/28337076/nebulized-gentamicin-as-an-alternative-to-nebulized-tobramycin-for-tracheitis-in-pediatric-patients
#1
Justin K Chen, Brittany L Martin-McNew, Lisa M Lubsch
OBJECTIVES: Tracheitis is an infection of the lower respiratory tract and is defined by the US Centers for Disease Control and Prevention (CDC) based on signs and symptoms with no radiographic evidence of pneumonia. One method of treatment involves the use of tobramycin given by nebulizer. The purpose of this study was to compare the safety and efficacy of nebulized gentamicin with nebulized tobramycin. METHODS: This study was conducted in patients under 21 years of age who received greater than or equal to 1 day of gentamicin, 80 mg, or tobramycin, 300 mg, given twice a day by nebulization within the 14-month study period...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28262569/pilot-trial-of-tobramycin-inhalation-powder-in-cystic-fibrosis-patients-with-chronic-burkholderia-cepacia-complex-infection
#2
Valerie Waters, Yvonne Yau, Trevor Beaudoin, Jillian Wettlaufer, Sean Kevin Tom, Nancy McDonald, Leena Rizvi, Michelle Klingel, Felix Ratjen, Elizabeth Tullis
There is no effective chronic suppressive therapy Burkholderia cepacia complex infection in cystic fibrosis (CF) patients. This was a pilot, open-label clinical trial of tobramycin inhalation powder (TIP) delivered via Podhaler twice daily for 28days in adults and children with CF and chronic B. cepacia complex infection in Toronto, Canada. A total of 10 subjects (4 pediatric, 6 adult patients) were treated. There was a mean drop of 1.4 log (CFU/ml) in sputum bacterial density (p=0.01) and sputum IL-8 levels decreased significantly after 28days of TIP (p=0...
March 2, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28184305/once-daily-aerosolised-tobramycin-in-adult-patients-with-cystic-fibrosis-in-the-management-of-pseudomonas-aeruginosa-chronic-infection
#3
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/28102546/ataluren-and-similar-compounds-specific-therapies-for-premature-termination-codon-class-i-mutations-for-cystic-fibrosis
#4
REVIEW
Aisha A Aslam, Colin Higgins, Ian P Sinha, Kevin W Southern
BACKGROUND: Cystic fibrosis is a common life-shortening genetic disorder in the Caucasian population (less common in other ethnic groups) caused by the mutation of a single gene that codes for the production of the cystic fibrosis transmembrane conductance regulator protein. This protein coordinates the transport of salt (and bicarbonate) across cell surfaces and the mutation most notably affects the airways. In the lungs of people with cystic fibrosis, defective protein results in a dehydrated surface liquid and compromised mucociliary clearance...
January 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28025037/impact-of-azithromycin-on-the-clinical-and-antimicrobial-effectiveness-of-tobramycin-in-the-treatment-of-cystic-fibrosis
#5
Dave P Nichols, Carrie L Happoldt, Preston E Bratcher, Silvia M Caceres, James F Chmiel, Kenneth C Malcolm, Milene T Saavedra, Lisa Saiman, Jennifer L Taylor-Cousar, Jerry A Nick
BACKGROUND: Concomitant use of oral azithromycin and inhaled tobramycin occurs in approximately half of US cystic fibrosis (CF) patients. Recent data suggest that this combination may be antagonistic. METHODS: Test the hypothesis that azithromycin reduces the clinical benefits of tobramycin by analyses of clinical trial data, in vitro modeling of P. aeruginosa antibiotic killing, and regulation of the MexXY efflux pump. RESULTS: Ongoing administration of azithromycin associates with reduced ability of inhaled tobramycin, as compared with aztreonam, to improve lung function and quality of life in a completed clinical trial...
December 24, 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/27970880/cost-effectiveness-of-levofloxacin-inhalation-solution-vs-aztreonam-inhalation-solution-and-tobramycin-dry-powder-for-inhalation-in-cystic-fibrosis-patients-in-sweden
#6
G Medic, K Franck-Larsson, M Wille, S Rodahl, M Hemels
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27886041/antimicrobial-susceptibility-of-pseudomonas-aeruginosa-before-and-after-initiation-of-inhaled-tobramycin-in-bulgaria
#7
Guergana Petrova, Tanya Strateva, Dimitrinka Miteva, Snezhina Lazova, Penka Perenovska
INTRODUCTION: In aim to achieve better infection control and possible eradication of the pathogens involved in chronic infections of patients with cystic fibrosis (CF) scientists have developed a new way to administer antimicrobials - inhalation. The first and so far the only available inhalable antimicrobial in Bulgaria is inhaled tobramycin (TOBI), introduced in 2009. We aimed to evaluate the antimicrobial susceptibility of Pseudomonas aeruginosa isolates from cystic fibrosis (CF) patients before and after initiation of TOBI in the regular treatment regimen...
November 24, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27850322/683-outcomes-comparing-inhaled-and-intravenous-tobramycin-in-ventilator-associated-pneumonia
#8
Paige Garber, Chris Droege, Eric Mueller, Neil Ernst, Molly Droege
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27822017/treatment-satisfaction-in-cystic-fibrosis-early-patient-experience-with-tobramycin-inhalation-powder
#9
Jonathan Greenberg, Jacqueline B Palmer, Wing W Chan, Catherine E Correia, Diane Whalley, Paul Shannon, Gregory S Sawicki
BACKGROUND: This study assessed treatment satisfaction of cystic fibrosis (CF) patients in a routine clinical setting for tobramycin inhalation powder (TIP), the first dry powder-inhaled antibiotic for Pseudomonas aeruginosa infection. METHODS: CF patients aged 6 years or older treated with at least one cycle of TIP completed a web survey on experience with TIP, including the Treatment Satisfaction Questionnaire for Medication (TSQM). Regression analysis determined the factors associated with TSQM global satisfaction...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27692977/comparison-of-inhaled-antibiotics-for-the-treatment-of-chronic-pseudomonas-aeruginosa-lung-infection-in-patients-with-cystic-fibrosis-systematic-literature-review-and-network-meta-analysis
#10
J Stuart Elborn, Anne-Lise Vataire, Ayako Fukushima, Samuel Aballea, Amine Khemiri, Curtis Moore, Goran Medic, Michiel E H Hemels
PURPOSE: In Europe, 4 inhaled antibiotics (tobramycin, colistimethate sodium, aztreonam, and levofloxacin) are currently approved for the treatment of chronic Pseudomonas aeruginosa lung infection in patients with cystic fibrosis (CF). Levofloxacin inhalation solution (LIS) is the most recently approved inhaled antibiotic for adult patients with CF. A systematic literature review and Bayesian network meta-analysis (NMA) was conducted to compare the relative short-term (4 weeks) and long-term (24 weeks) outcomes of these inhaled antibiotics versus LIS...
October 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27679516/the-delivery-of-high-dose-dry-powder-antibiotics-by-a-low-cost-generic-inhaler
#11
Thaigarajan Parumasivam, Sharon S Y Leung, Patricia Tang, Citterio Mauro, Warwick Britton, Hak-Kim Chan
The routine of loading multiple capsules for delivery of high-dose antibiotics is time consuming, which may reduce patient adherence to inhaled treatment. To overcome this limitation, an investigation was carried out using four modified versions of the Aerolizer® that accommodate a size 0 capsule for delivery of high payload formulations. In some prototypes, four piercing pins of 0.6 mm each were replaced with a single centrally located 1.2-mm pin and one-third reduced air inlet of the original design. The performance of these inhalers was evaluated using spray-dried antibiotic powders with distinct morphologies: spherical particles with a highly corrugated surface (colistin and tobramycin) and needle-like particles (rifapentine)...
January 2017: AAPS Journal
https://www.readbyqxmd.com/read/27628783/investigation-of-the-enhanced-antimicrobial-activity-of-combination-dry-powder-inhaler-formulations-of-lactoferrin
#12
Lindsay J Marshall, Wilson Oguejiofor, Robert Price, Jagdeep Shur
The airways of most people with cystic fibrosis are colonized with biofilms of the Gram-negative, opportunistic pathogen Pseudomonas aeruginosa. Delivery of antibiotics directly to the lung in the form of dry powder aerosols offers the potential to achieve high local concentrations directly to the biofilms. Unfortunately, current aerosolised antibiotic regimes are unable to efficiently eradicate these biofilms from the airways. We investigated the ability of the innate antimicrobial, lactoferrin, to enhance the activity of two aminoglycoside antibiotics (tobramycin and gentamicin) against biofilms of P...
December 5, 2016: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/27586437/the-story-of-cystic-fibrosis-1965-2015
#13
John Massie, Phillip J Robinson, Peter J Cooper
There have been dramatic changes in the care of children with cystic fibrosis (CF) from 1965 to 2015. The initial improvements were the result of incremental gains in medical knowledge and better use of available therapies. Some CF-specific drugs were developed (recombinant human DNase and purified tobramycin for inhalation), but these simply delayed the progression of the lung damage. The discovery of the CF transmembrane conductance regulator gene in 1989 created an explosion of knowledge of airway biology and CF pathophysiology...
September 1, 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27576543/sequential-inhalational-tobramycin-colistin-combination-in-cf-patients-with-chronic-p-aeruginosa-colonization-an-observational-study
#14
MULTICENTER STUDY
Joachim Riethmüller, Gloria Herrmann, Ute Graepler-Mainka, Dorothea Hellwig, Hans-Eberhard Heuer, Susanne Heyder, Holger Köster, Birte Kinder, Kristina Kröger, Klaus Paul, Krystyna Poplawska, Volker O Melichar, Christina Smaczny, Uwe Mellies
BACKGROUND/AIMS: In cystic fibrosis (CF), chronic microbial lung infections are difficult to treat and cause morbidity and increased mortality. METHODS: In a multicentre, open-label, exploratory, non-interventional study, inhaled tobramycin (300 mg twice daily) and colistin (1 million I.U. twice daily) were sequentially combined with the aim to investigate the effect on 41 CF patients with chronic P. aeruginosa infections for six months (mean age 24 ± 10.8y). RESULTS: Six patients had adverse events that were assessed as being related to treatment...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27563934/dry-powder-inhaler-delivery-of-tobramycin-in-in-vitro-models-of-tracheostomized-children
#15
Wallace B Wee, Scott Tavernini, Andrew R Martin, Israel Amirav, Carina Majaesic, Warren H Finlay
BACKGROUND: Pediatric tracheostomies are not uncommon and aerosols allow for targeted lung therapy. However, there is little literature that quantifies aerosol delivery through tracheostomies. Nebulizers are commonly used in delivering tobramycin, but there are drawbacks, for example, time burden. Dry powder inhalers (DPIs) can deliver higher payloads in less time. However, no data exist assessing DPIs with tracheostomies. OBJECTIVE: The study's aim was to quantify the amount of aerosolized tobramycin delivered to the lungs of in vitro tracheostomized spontaneously breathing pediatric models with the TOBI(®) Podhaler™ (Podhaler) and the PARI LC Plus(®) (LC Plus)...
February 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/27522066/successful-use-of-ceftolozane-tazobactam-to-treat-a-pulmonary-exacerbation-of-cystic-fibrosis-caused-by-multidrug-resistant-pseudomonas-aeruginosa
#16
Stephen B Vickery, David McClain, Kurt A Wargo
Ceftolozane-tazobactam, a novel β-lactam/β-lactamase inhibitor, was recently approved for the treatment of complicated urinary tract and intraabdominal infections, as monotherapy and in combination with metronidazole, respectively. Ceftolozane-tazobactam exhibits a wide spectrum of activity against both gram-positive bacteria, gram-negative bacteria including multidrug-resistant (MDR) Pseudomonas aeruginosa, and some anaerobic bacteria. Although not currently approved for any pulmonary indication, studies have demonstrated excellent distribution to epithelial lining fluid, indicating that it may be an alternative agent to use in the treatment of respiratory tract infections caused by MDRP...
October 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27507832/antibiotic-therapy-for-stable-non-cf-bronchiectasis-in-adults-a-systematic-review
#17
Katrine Fjaellegaard, Melda Dönmez Sin, Andrea Browatzki, Charlotte Suppli Ulrik
To provide an update on efficacy and safety of antibiotic treatments for stable non-cystic fibrosis (CF) bronchiectasis (BE). Systematic review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was done. Twenty-six studies (1.898 patients) fulfilled the inclusion criteria. Studies of inhaled tobramycin have revealed conflicting results regarding quality of life (QoL), exacerbations and admissions, but may result in sputum cultures negative for Pseudomonas aeruginosa, whereas studies investigating the effect of inhaled gentamycin have shown positive effects on sputum bacterial density, decrease in sputum cultures positive for P...
August 9, 2016: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/27444885/efficacy-of-species-specific-protein-antibiotics-in-a-murine-model-of-acute-pseudomonas-aeruginosa-lung-infection
#18
Laura C McCaughey, Neil D Ritchie, Gillian R Douce, Thomas J Evans, Daniel Walker
Protein antibiotics, known as bacteriocins, are widely produced by bacteria for intraspecies competition. The potency and targeted action of bacteriocins suggests that they could be developed into clinically useful antibiotics against highly drug resistant Gram-negative pathogens for which there are few therapeutic options. Here we show that Pseudomonas aeruginosa specific bacteriocins, known as pyocins, show strong efficacy in a murine model of P. aeruginosa lung infection, with the concentration of pyocin S5 required to afford protection from a lethal infection at least 100-fold lower than the most commonly used inhaled antibiotic tobramycin...
July 22, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27435882/long-term-safety-of-tobramycin-inhalation-powder-in-patients-with-cystic-fibrosis-phase-iv-etoiles-study
#19
Urte Sommerwerck, Isabel Virella-Lowell, Gerhild Angyalosi, Andrea Viegas, Weihua Cao, Laurie Debonnett
OBJECTIVE: Long-term treatment with inhaled antibiotics is recommended for chronic Pseudomonas aeruginosa (Pa) infection in cystic fibrosis (CF) patients. The ETOILES study (Clinicaltrials.gov identifier: NCT01519661) evaluated the safety of tobramycin inhalation powder (TIP) for 1 year. RESEARCH DESIGN AND METHODS: This single-arm, open-label, multicenter, phase IV trial, enrolled CF patients aged ≥6 years, with baseline FEV1 ≥25%-≤75% predicted and Pa infection, and assessed the safety of TIP over six cycles in terms of the incidence of treatment-emergent adverse events (AEs) and serious AEs (SAEs)...
November 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27393775/chronic-rhinosinusitis-in-patients-with-cystic-fibrosis
#20
Daniel L Hamilos
Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and accounts for significant morbidity and contribution to CF lung disease. Mutations of the cystic fibrosis transmembrane regulator gene occur with increased prevalence in patients with CRS without CF, suggesting some contribution to CRS pathophysiology. Nasal polyps (NPs) occur with increased prevalence in patients with CF of all ages and have a more neutrophilic appearance with fewer eosinophils and increased submucosal glandular elements in comparison to NPs from patients without CF...
July 2016: Journal of Allergy and Clinical Immunology in Practice
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