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Inhalated therapy antibiotic

Eva Polverino, Graham H Bothamley, Delia Goletti, Jan Heyckendorf, Giovanni Sotgiu, Stefano Aliberti
The breadth and quality of scientific presentations on clinical and translational research into respiratory infections at the 2015 European Respiratory Society (ERS) International Congress in Amsterdam, the Netherlands, establishes this area as one of the leadings fields in pulmonology. The host-pathogen relationship in chronic obstructive pulmonary disease, and the impact of comorbidities and chronic treatment on clinical outcomes in patients with pneumonia were studied. Various communications were dedicated to bronchiectasis and, in particular, to different prognostic and clinical aspects of this disease, including chronic infection with Pseudomonas and inhaled antibiotic therapy...
July 2016: ERJ Open Research
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
C Van de Kerkhove, P C Goeminne, M Kicinski, T S Nawrot, N Lorent, P Van Bleyenbergh, K De Boeck, L J Dupont
INTRODUCTION: The efficacy of inhaled antibiotics to treat chronic Pseudomonas aeruginosa pulmonary infection in patients with cystic fibrosis (CF) has been well established. Few data are available on the value of continuous alternating inhaled antibiotic therapy (CAIT), a strategy increasingly used in the management of CF. OBJECTIVE: To investigate the effect of CAIT on clinical outcome in adult CF patients treated at the University Hospital Leuven. METHODS: Patients with a documented CF diagnosis who received inhaled antibiotics between March 2010 and January 2015 were retrospectively evaluated...
October 5, 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Xiaoming Yuan, Guangrong Zhou, Yan He, Aiwen Feng
BACKGROUND: Epithelial dysplasia and adenomatous polyps of colorectum are precancerous lesions. Surgical removal is still one of the important treatment approaches for colorectal polyps. CASE PRESENTATION: A male patient over 78 years was admitted due to bloody stool and abdominal pain. Colonoscopic biopsy showed a high-grade epithelial dysplasia in an adenomatous polyp of sigmoid colon. Anemia, COPD, ischemic heart disease (IHD), arrhythmias, and hypoproteinemia were comorbidities...
September 26, 2016: World Journal of Surgical Oncology
Adam T Hill
Long-term macrolide therapy offers an evidence-based treatment to reduce frequent exacerbations in stable adult patients with bronchiectasis. There is limited evidence that they also attenuate the decline in lung function and improve health-related quality of life. The benefits and risks of long-term macrolides need to be clearly explored for individual patients. Further work is needed to understand the optimal drug, dose and regimen, the mechanisms behind these benefits, appropriate patient selection, sustainability of efficacy, potential long-term risk on the lung microbiome, and their placement with or without inhaled antibiotic treatment...
August 31, 2016: Chest
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
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
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
E B Katinas, G V Lavrenova, E Yu Glukhova, L R Kucherova
The objective of the present work was to elaborate a scheme for the effective combined treatment ofinflammation of the rhinosinusotubal area including the local administration of roncoleukin and cyclopheron without antibiotics. The study included 82 patients (27 men and 55 women) at the age from 25 to 55 years presenting with acute inflammation ofroncoleukin and cycloferon. They were divided into two groups. Group 1 was comprised of 39 patients dominated by those with the clinical picture of sinusitis whereas group 2 contained 43 patients in whom symptoms of catarrhal otitis media prevailed...
2016: Vestnik Otorinolaringologii
Francesco Blasi, Clive Page, Gian Maria Rossolini, Lucia Pallecchi, Maria Gabriella Matera, Paola Rogliani, Mario Cazzola
OBJECTIVES: In airway infections, biofilm formation has been demonstrated to be responsible for both acute and chronic events, and constitutes a genuine challenge in clinical practice. Difficulty in eradicating biofilms with systemic antibiotics has led clinicians to consider the possible role of non-antibiotic therapy. The aim of this review is to examine current evidence for the use of N-acetylcysteine (NAC) in the treatment of biofilm-related respiratory infections. METHODS: Electronic searches of PUBMED up to September 2015 were conducted, searching for 'biofilm', 'respiratory tract infection', 'N-acetylcysteine', 'cystic fibrosis', 'COPD', 'bronchiectasis', 'otitis', and 'bronchitis' in titles and abstracts...
August 2016: Respiratory Medicine
Robert Wilson, Timothy Aksamit, Stefano Aliberti, Anthony De Soyza, J Stuart Elborn, Pieter Goeminne, Adam T Hill, Rosario Menendez, Eva Polverino
BACKGROUND: An Expert Forum was held at the 2014 European Respiratory Society International Congress to address issues involved in the management of Pseudomonas aeruginosa infection in patients with non-cystic fibrosis bronchiectasis (NCFB). Multiple studies have found that chronic P. aeruginosa infection is associated with more severe disease and higher morbidity and mortality. OVERVIEW: Participants discussed appropriate management of P. aeruginosa infection at three stages: 1) first isolation, including eradication protocols; 2) during exacerbations; and 3) during chronic infection, including long-term antibiotic therapy to reduce the severity of symptoms and frequency of exacerbations...
August 2016: Respiratory Medicine
Brent J Yamamoto, Annette M Shadiack, Sarah Carpenter, Daniel Sanford, Lisa N Henning, Nestor Gonzales, Edward O'Connor, Leslie S Casey, Natalya V Serbina
The Centers for Disease Control and Prevention recommend adjunctive antitoxins when systemic anthrax is suspected. Obiltoxaximab, a monoclonal antibody against protective antigen (PA), is approved for treatment of inhalational anthrax in combination with antibiotics and for prophylaxis when alternative therapies are not available. The impact of toxin neutralization with obiltoxaximab during pre- and postexposure prophylaxis was explored, and efficacy results that supported the prophylaxis indication are presented here...
October 2016: Antimicrobial Agents and Chemotherapy
Steve Turner, Kathryn Richardson, Clare Murray, Mike Thomas, Elizabeth V Hillyer, Anne Burden, David B Price
BACKGROUND: Adding a long-acting β2-agonist (LABA) to inhaled corticosteroids (ICS) using a fixed-dose combination (FDC) inhaler is the UK guideline recommendation for children aged more than 4 years with uncontrolled asthma. The evidence of benefit of adding an FDC inhaler over a separate LABA inhaler is limited. OBJECTIVE: The objective of this study was to compare the effectiveness of a LABA added as an FDC inhaler, and as a separate inhaler, in children with uncontrolled asthma...
July 12, 2016: Journal of Allergy and Clinical Immunology in Practice
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...
2016: Cochrane Database of Systematic Reviews
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
Matthias Kappler, Felicitas Nagel, Maria Feilcke, Carolin Kröner, Ingo Pawlita, Susanne Naehrig, Jan Ripper, Meike Hengst, Ulrich von Both, Maria Forstner, Andreas Hector, Matthias Griese
OBJECTIVE: To retrospectively identify CF patients with methicillin resistant Staphylococcus aureus (MRSA) and to assess the long-term success of an eradication scheme introduced in 2002 for all newly colonized patients. PATIENTS: All microbiological results from all 505 CF patients followed between 2002 and 2012 were analyzed focusing on the detection of MRSA. METHODS: Retrospective patient record analysis of MRSA positive CF patients regarding eradication and clinical outcome...
July 5, 2016: Pediatric Pulmonology
Shoroq M Altawalbeh, Carolyn T Thorpe, Janice C Zgibor, Sandra Kane-Gill, Yihuang Kang, Joshua M Thorpe
OBJECTIVES: To compare the effectiveness and cardiovascular safety of long-acting beta-agonists (LABAs) with those of leukotriene receptor antagonists (LTRAs) as add-on treatments in older adults with asthma already taking inhaled corticosteroids (ICSs). DESIGN: Retrospective cohort study. SETTING: Medicare fee-for-service (FFS) claims (2009-10) for a 10% random sample of beneficiaries continuously enrolled in Parts A, B, and D in 2009. PARTICIPANTS: Medicare beneficiaries aged 66 and older continuously enrolled in FFS Medicare with Part D coverage with a diagnosis of asthma before 2009 treated exclusively with ICSs plus LABAs or ICSs plus LTRAs (N = 14,702)...
August 2016: Journal of the American Geriatrics Society
Susanna Esposito, Chiara Rosazza, Calogero Sathya Sciarrabba, Nicola Principi
Upper respiratory tract infections (URTIs), primarily acute rhinopharyngitis, tonsillitis, adenoiditis, and rhinosinusitis (RS), are major causes of morbidity in both children and adults of any age. In addition to the frequent occurrence of related medical problems and the associated socioeconomic costs, URTIs have a significant impact on the quality of life of patients and their families, and have placed an escalating financial burden on the global healthcare system. Most URTIs are caused by viruses and require only symptomatic treatment...
June 23, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Sameer S Kadri, Andrew C Miller, Samuel Hohmann, Stephanie Bonne, Carrie Nielsen, Carmen Wells, Courtney Gruver, Sadeq A Quraishi, Junfeng Sun, Rongman Cai, Peter E Morris, Bradley D Freeman, James H Holmes, Bruce A Cairns, Anthony F Suffredini
BACKGROUND: Mortality after smoke inhalation-associated acute lung injury (SI-ALI) remains substantial. Age and burn surface area are risk factors of mortality, while the impact of patient and center-level variables and treatments on survival are unknown. METHODS: We performed a retrospective cohort study of burn and non-burn centers at 68 United States academic medical centers from 2011-2014. Adult SI-ALI inpatients were identified using an algorithm based on a billing code for respiratory conditions from smoke inhalation who were mechanically ventilated by hospital day 4, with either a length-of-stay ≥ 5-days or death within 4 days of hospitalization...
June 14, 2016: Chest
N Emiralioglu, E Yalcin, A Meral, B Sener, D Dogru, U Ozcelik, N Kiper
WHAT IS KNOWN AND OBJECTIVE: Antibiotic therapy aimed at eradicating Pseudomonas aeruginosa (Pa), and improved regimens to treat chronic Pa infection have played a major role in increasing the median survival of patients with cystic fibrosis (CF). However, different clinical centres use varying eradication regimens. The aim of this study was to evaluate the efficacy of multiple eradication treatments against initial Pa infection and to determine the factors affecting the treatment success...
August 2016: Journal of Clinical Pharmacy and Therapeutics
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