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Inhaled tobramycin

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https://www.readbyqxmd.com/read/29740404/inhalational-gentamicin-treatment-is-effective-against-pneumonic-plague-in-a-mouse-model
#1
David Gur, Itai Glinert, Moshe Aftalion, Yaron Vagima, Yinon Levy, Shahar Rotem, Ayelet Zauberman, Avital Tidhar, Arnon Tal, Sharon Maoz, Raphael Ber, Avi Pass, Emanuelle Mamroud
Pneumonic plague is an infectious disease characterized by rapid and fulminant development of acute pneumonia and septicemia that results in death within days of exposure. The causative agent of pneumonic plague, Yersinia pestis (Y. pestis) , is a Tier-1 bio-threat agent. Parenteral antibiotic treatment is effective when given within a narrow therapeutic window after symptom onset. However, the non-specific "flu-like" symptoms often lead to delayed diagnosis and therapy. In this study, we evaluated inhalational gentamicin therapy in an infected mouse model as a means to improve antibiotic treatment efficacy...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29724399/treatment-compliance-in-cystic-fibrosis-patients-with-chronic-pseudomonas-aeruginosa-infection-treated-with-tobramycin-inhalation-powder-the-free-study
#2
Francesco Blasi, Vincenzo Carnovale, Giuseppe Cimino, Vincenzina Lucidi, Donatello Salvatore, Barbara Messore, Marta Bartezaghi, Elisa Muscianisi, Pasquale Alberto Porpiglia
BACKGROUND: A high treatment burden with nebulised therapies in cystic fibrosis (CF) patients is the major limitation for treatment compliance; moreover, studies on treatment compliance with inhaled antibiotics are limited. This study assessed compliance to TOBI® Podhaler™ (TIP) treatment in CF patients with chronic Pseudomonas aeruginosa (Pa) infections in a real-world setting using the Italian Treatment Adherence CF Questionnaire (ITA-CFq). METHODS: This longitudinal, multicentre, cohort study included 2 follow-up (FU) visits: FU-1 at 3-months±15-days from the baseline visit and FU-2 at the end of third TIP cycle (or 6-months after enrolment, whichever occurred first)...
May 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29720915/resource-use-evaluation-of-tobramycin-formulations-in-a-state-medicaid-program
#3
Shellie L Keast
OBJECTIVE: Patients with cystic fibrosis (CF) often suffer from chronic infection with Pseudomonas aeruginosa. For patients with CF, 6 years of age and older, with P aeruginosa persistently present in cultures of the airways, the Cystic Fibrosis Foundation recommends the chronic use of inhaled tobramycin to reduce exacerbations. To ease treatment burden, a new dry powder formulation was developed. The objective of this research was to compare resource utilization between tobramycin inhaled solution (TIS) and a new tobramycin dry powder (TIP) formulation in a state Medicaid program...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29685813/eradication-of-early-p-aeruginosa-infection-in-children-7-years-of-age-with-cystic-fibrosis-the-early-study
#4
Felix Ratjen, Alexander Moeller, Martha L McKinney, Irina Asherova, Nipa Alon, Robert Maykut, Gerhild Angyalosi
OBJECTIVE: Antibiotic eradication treatment is the standard-of-care for cystic fibrosis (CF) patients with early Pseudomonas aeruginosa (Pa)-infection; however, evidence from placebo-controlled trials is limited. METHODS: This double-blind, placebo-controlled trial randomised CF patients <7 years (N = 51) with early Pa-infection to tobramycin inhalation solution (TOBI 300 mg) or placebo (twice daily) for 28 days with an optional cross-over on Day 35...
April 20, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/29679678/characterisation-of-40-mg-ml-and-100-mg-ml-tobramycin-formulations-for-aerosol-therapy-with-adult-mechanical-ventilation
#5
Jayesh A Dhanani, Patrician Tang, Steven C Wallis, Suzanne L Parker, Preeti Pandey, John F Fraser, Jeremy Cohen, Adrian Barnett, Jason R Roberts, Hak-Kim Chan
BACKGROUND: Preservative-free tobramycin is commonly used as aerosolized therapy for ventilator associated pneumonia. The comparative delivery profile of the formulations of two different concentrations (100 mg/ml and 40 mg/ml) is unknown. This study aims to evaluate the aerosol characteristics of these tobramycin formulations in a simulated adult mechanical ventilation model. METHODS: Simulated adult mechanical ventilation set up and optimal settings were used in the study...
April 18, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29607494/inhaled-anti-pseudomonal-antibiotics-for-long-term-therapy-in-cystic-fibrosis
#6
REVIEW
Sherie Smith, Nicola J Rowbotham, Kate H Regan
BACKGROUND: Inhaled antibiotics are commonly used to treat persistent airway infection with Pseudomonas aeruginosa that contributes to lung damage in people with cystic fibrosis. Current guidelines recommend inhaled tobramycin for individuals with cystic fibrosis and persistent Pseudomonas aeruginosa infection who are aged six years or older. The aim is to reduce bacterial load in the lungs so as to reduce inflammation and deterioration of lung function. This is an update of a previously published review...
March 30, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29525410/early-detection-using-qpcr-of-pseudomonas-aeruginosa-infection-in-children-with-cystic-fibrosis-undergoing-eradication-treatment
#7
Ana C Blanchard, Ashley M Rooney, Yvonne Yau, Yu Zhang, Patrick J Stapleton, Eric Horton, Michelle Klingel, Sanja Stanojevic, Felix Ratjen, Bryan Coburn, Valerie Waters
BACKGROUND: Infection with Pseudomonas aeruginosa (Pa) with a chronic phenotype is associated with antibiotic eradication therapy (AET) failure. Our objective was to determine whether higher levels of Pa (detected using qPCR) prior to culture positivity were associated with AET failure in pediatric CF patients. METHODS: Pa-specific qPCR was performed on stored sputa prior to culture positivity in pediatric CF patients with new-onset culture-positive Pa infections undergoing AET with a 28-day course of tobramycin-inhaled solution (TIS)...
March 7, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/29512893/outcome-evaluation-of-a-pharmacy-based-therapy-management-program-for-patients-with-cystic-fibrosis
#8
Heather S Kirkham, Francis Staskon, Nishita Hira, Darren McLane, Karl M Kilgore, Alexis Parente, Seung Kim, Gregory S Sawicki
OBJECTIVE: To compare medication adherence, pulmonary exacerbations, healthcare utilization, and costs for patients with cystic fibrosis (CF) who utilized a pharmacy-based therapy management program to a matched control group. We hypothesized that patient management services would be associated with better medication adherence, and thus require fewer visits to the emergency room or hospitalizations. METHODS: This retrospective, observational cohort study used claims data from the MORE2 claims Registry®...
March 7, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29356436/health-insurance-and-use-of-recommended-routine-care-in-adults-with-cystic-fibrosis
#9
Susan S Li, Don Hayes, Joseph D Tobias, Wayne J Morgan, Dmitry Tumin
BACKGROUND: Low socioeconomic status is correlated with worse outcomes in patients with cystic fibrosis (CF). Whether insurance status impacts adherence to care in this population is unknown. METHODS: Patients ≥18 years old in the CF Foundation Patient Registry (2005-2013) were grouped based on reported annual insurance as private, public (Medicaid, Medicare or state medical assistance program), others or no insurance. Random effects logistic regression evaluated association between change in insurance status and annual use of recommended routine care...
January 22, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29206744/detectable-concentrations-of-inhaled-tobramycin-in-critically-ill-children-without-cystic-fibrosis-should-routine-monitoring-be-recommended
#10
Jamie L Miller, Trisha M Lepa, Courtney Ranallo, Hala Chaaban, Grant H Skrepnek, Peter N Johnson
OBJECTIVES: To determine the percentage of detectable tobramycin troughs and acute kidney injury in critically ill children without cystic fibrosis on inhaled therapy. DESIGN: Historic cohort. SETTING: Academic hospital. PATIENTS: Forty children less than 18 years receiving inhaled tobramycin across 6.5 years. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary objective was to determine the percentage of detectable tobramycin troughs greater than or equal to 0...
December 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29098998/the-emergence-of-multidrug-resistant-pseudomonas-aeruginosa-in-cystic-fibrosis-patients-on-inhaled-antibiotics
#11
Atqah AbdulWahab, Khalid Zahraldin, Mazen A Sid Ahmed, Sulieman Abu Jarir, Mohammed Muneer, Shehab F Mohamed, Jemal M Hamid, Abubaker A I Hassan, Emad Bashir Ibrahim
INTRODUCTION: Multidrug-resistant Pseudomonas aeruginosa (MDR-PA) is an important and growing issue in the care of patients with cystic fibrosis (CF), and a major cause of morbidity and mortality. OBJECTIVE: The objective of the study was to describe the frequency of MDR-PA recovered from the lower respiratory samples of pediatric and adult CF patients, and its antibiotic resistance pattern to commonly used antimicrobial agents including β-lactams, aminoglycosides, and fluoroquinolones...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29062489/-staphylococcus-aureus-interaction-with-pseudomonas-aeruginosa-biofilm-enhances-tobramycin-resistance
#12
T Beaudoin, Y C W Yau, P J Stapleton, Y Gong, P W Wang, D S Guttman, V Waters
Antimicrobial resistance is a significant threat to the treatment of infectious disease. Multiple mechanisms of resistance to different classes of antibiotics have been identified and well-studied. However, these mechanisms are studied with bacteria in isolation, whereas often, infections have a polymicrobial basis. Using a biofilm slide chamber model, we visualized the formation and development of clinical Pseudomonas aeruginosa biofilms in the presence of secreted Staphylococcus aureus exoproducts, two bacteria that commonly co-infect pediatric patients with cystic fibrosis...
2017: NPJ Biofilms and Microbiomes
https://www.readbyqxmd.com/read/29053080/aerosolizing-lipid-dispersions-enables-antibiotic-transport-across-mimics-of-the-lung-airway-surface-even-in-the-presence-of-pre-existing-lipid-monolayers
#13
Steven V Iasella, Amy Z Stetten, Timothy E Corcoran, Stephen Garoff, Todd M Przybycien, Robert D Tilton
BACKGROUND: Secondary lung infections are the primary cause of morbidity associated with cystic fibrosis lung disease. Aerosolized antibiotic inhalation is potentially advantageous but has limited effectiveness due to altered airway aerodynamics and deposition patterns that limit drug access to infected regions. One potential strategy to better reach infected areas is to formulate aerosols with surfactants that induce surface tension gradients and drive postdeposition drug dispersal via Marangoni transport along the airway surface liquid (ASL)...
October 20, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/29029057/patient-specific-modelling-of-regional-tobramycin-concentration-levels-in-airways-of-patients-with-cystic-fibrosis-can-we-dose-once-daily
#14
Aukje C Bos, Johan W Mouton, Mireille van Westreenen, Eleni-Rosalina Andrinopoulou, Hettie M Janssens, Harm A W M Tiddens
Background: Inhaled tobramycin is important in the treatment of Pseudomonas aeruginosa (Pa) infections in cystic fibrosis (CF). However, despite its use it fails to attenuate the clinical progression of CF lung disease. The bactericidal efficacy of tobramycin is known to be concentration-dependent and hence changing the dosing regimen from a twice-daily (q12h) inhalation to a once-daily (q24h) inhaled double dose could improve treatment outcomes. Objectives: To predict local concentrations of nebulized tobramycin in the airways of patients with CF, delivered with the small airway-targeting Akita® system or standard PARI-LC® Plus system, with different inspiratory flow profiles...
December 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28854668/current-and-future-therapies-for-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#15
Wynne D Smith, Emmanuelle Bardin, Loren Cameron, Claire L Edmondson, Katie V Farrant, Isaac Martin, Ronan A Murphy, Odel Soren, Andrew R Turnbull, Natasha Wierre-Gore, Eric W Alton, Jacob G Bundy, Andrew Bush, Gary J Connett, Saul N Faust, Alain Filloux, Paul S Freemont, Andrew L Jones, Zoltan Takats, Jeremy S Webb, Huw D Williams, Jane C Davies
Pseudomonas aeruginosa opportunistically infects the airways of patients with cystic fibrosis and causes significant morbidity and mortality. Initial infection can often be eradicated though requires prompt detection and adequate treatment. Intermittent and then chronic infection occurs in the majority of patients. Better detection of P. aeruginosa infection using biomarkers may enable more successful eradication before chronic infection is established. In chronic infection P. aeruginosa adapts to avoid immune clearance and resist antibiotics via efflux pumps, β-lactamase expression, reduced porins and switching to a biofilm lifestyle...
August 1, 2017: FEMS Microbiology Letters
https://www.readbyqxmd.com/read/28750737/low-dose-nitric-oxide-as-targeted-anti-biofilm-adjunctive-therapy-to-treat-chronic-pseudomonas-aeruginosa-infection-in-cystic-fibrosis
#16
Robert P Howlin, Katrina Cathie, Luanne Hall-Stoodley, Victoria Cornelius, Caroline Duignan, Raymond N Allan, Bernadette O Fernandez, Nicolas Barraud, Ken D Bruce, Johanna Jefferies, Michael Kelso, Staffan Kjelleberg, Scott A Rice, Geraint B Rogers, Sandra Pink, Caroline Smith, Priya S Sukhtankar, Rami Salib, Julian Legg, Mary Carroll, Thomas Daniels, Martin Feelisch, Paul Stoodley, Stuart C Clarke, Gary Connett, Saul N Faust, Jeremy S Webb
Despite aggressive antibiotic therapy, bronchopulmonary colonization by Pseudomonas aeruginosa causes persistent morbidity and mortality in cystic fibrosis (CF). Chronic P. aeruginosa infection in the CF lung is associated with structured, antibiotic-tolerant bacterial aggregates known as biofilms. We have demonstrated the effects of non-bactericidal, low-dose nitric oxide (NO), a signaling molecule that induces biofilm dispersal, as a novel adjunctive therapy for P. aeruginosa biofilm infection in CF in an ex vivo model and a proof-of-concept double-blind clinical trial...
September 6, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28662114/novel-glycopolymer-sensitizes-burkholderia-cepacia-complex-isolates-from-cystic-fibrosis-patients-to-tobramycin-and-meropenem
#17
Vidya P Narayanaswamy, Scott Giatpaiboon, Shenda M Baker, William P Wiesmann, John J LiPuma, Stacy M Townsend
Burkholderia cepacia complex (Bcc) infection, associated with cystic fibrosis (CF) is intrinsically multidrug resistant to antibiotic treatment making eradication from the CF lung virtually impossible. Infection with Bcc leads to a rapid decline in lung function and is often a contraindication for lung transplant, significantly influencing morbidity and mortality associated with CF disease. Standard treatment frequently involves antibiotic combination therapy. However, no formal strategy has been adopted in clinical practice to guide successful eradication...
2017: PloS One
https://www.readbyqxmd.com/read/28643178/economic-evaluation-of-tobramycin-inhalation-powder-for-the-treatment-of-chronic-pulmonary-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#18
Srilekha Panguluri, Praveen Gunda, Laurie Debonnett, Kamal Hamed
BACKGROUND: Chronic lung infection with Pseudomonas aeruginosa occurs in approximately 50% of patients with cystic fibrosis (CF). This infection further compromises lung function, and significantly contributes to the increased healthcare costs. OBJECTIVES: Inhaled tobramycin, used to manage P. aeruginosa infection in CF patients, is available as powder (tobramycin inhalation powder, TIP) and solution (tobramycin inhalation solution, TIS). Evidence suggests increased adherence with the use of TIP over TIS...
August 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28634121/population-pharmacokinetics-of-tobramycin-inhalation-solution-in-pediatric-patients-with-cystic-fibrosis
#19
Xinting Wang, Stephan Koehne-Voss, SivaNaga S Anumolu, Jing Yu
Tobramycin inhalation solution given as a twice daily inhalation of nebulized aerosols of 300 mg is approved for the treatment of Pseudomonas aeruginosa infection in cystic fibrosis patients over 6 years of age. To investigate tobramycin pharmacokinetics (PK) after inhalation of tobramycin in pediatric cystic fibrosis patients below 7 years, a population PK approach was used to evaluate tobramycin PK data in patients 6 months to 44 years of age from 4 clinical studies. The final model used a 2-compartmental, first-order absorption model with effect of body mass index on the apparent central volume of distribution...
June 17, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28614995/ease-of-use-of-tobramycin-inhalation-powder-compared-with-nebulized-tobramycin-and-colistimethate-sodium-a-crossover-study-in-cystic-fibrosis-patients-with-pulmonary-pseudomonas-aeruginosa-infection
#20
James Greenwood, Carsten Schwarz, Urte Sommerwerck, Edward F Nash, Michael Tamm, Weihua Cao, Paul Mastoridis, Laurie Debonnett, Kamal Hamed
BACKGROUND: This study assessed the ease of use of tobramycin inhalation powder (TIP) administered via T-326 inhaler versus tobramycin inhalation solution (TIS) and colistimethate sodium (COLI), both administered via nebulizers, for the treatment of chronic pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF). METHODS: A real-world, open-label, crossover, interventional phase IV study was conducted in CF patients aged ⩾6 years with forced expiratory volume in 1 second (FEV1) ⩾25% to ⩽90% predicted...
July 2017: Therapeutic Advances in Respiratory Disease
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