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Inhalated therapy antibiotic

Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
B Xing, J T Lin, H P Tang, L Yang, Y D Yuan, Y H Gu, P Chen, X J Liu, J Zhang, H G Liu, C Z Wang, W Zhou, D J Sun, Y Q Chen, Z C Chen, M Huang, Q C Lin, C P Hu, X H Yang, J M Huo, X W Ye, X Zhou, P Jiang, W Zhang, Y J Huang, L M Dai, R Y Liu, S X Cai, J Y Xu, J Y Zhou
Objective: To study the treatment of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during Jan 2013 to Dec 2014. Information of the demographic features, the severity of the exacerbation, the medicine prescribed during the hospitalization and the use of mechanical ventilation were collected and analyzed. Results: During the study period, there were 3 240 patients hospitalized for asthma exacerbation, and 1 369(42...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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
Lajos Szentgyorgyi, Chloe Shepherd, Ken W Dunn, Peter Fawcett, Julian M Barker, Paul Exton, Marc O Maybauer
Extracorporeal membrane oxygenation (ECMO) is one of the most frequent forms of extracorporeal life support (ECLS) and can be used as rescue therapy in patients with severe respiratory failure resulting from burns and/or smoke inhalation injury. Experience and literature on this treatment option is still very limited, consequently results are varied. We report a retrospective analysis of our experience with veno-venous (VV) ECMO in burn patients. All five patients, three male and two female (age: 28-37 years) had flame type burns and smoke inhalation injury...
February 27, 2018: Burns: Journal of the International Society for Burn Injuries
Jessica Mak, Ayman Al Habeeb, Mona Al Kalabi, Afsaneh Alavi
Blastomyces dermatitidis is typically contracted through inhalation of the dimorphic conidia, resulting in pulmonary infection as well as extrapulmonary disease through hematogenous spread. Blastomycosis is considered one of the great mimickers in medicine, with verrucous cutaneous blastomycosis resembling skin malignancy and B dermatitidis pulmonary infections often confused with lung cancer. Cutaneous blastomycosis can also often mimic pyoderma gangrenosum and should be considered in the differential diagnosis in any suspected case...
February 1, 2018: Journal of Cutaneous Medicine and Surgery
Matthew L Bradshaw, Alexandre Déragon, Pramod Puligandla, Guillaume Emeriaud, Anne-Marie Canakis, Patricia S Fontela
OBJECTIVE: To describe management practices and the factors guiding admission and treatment decisions for viral bronchiolitis across Canadian pediatric intensive care units (PICUs). DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists. MEASUREMENTS AND MAIN RESULTS: A survey using two case scenarios (non-intubated vs intubated patients) was developed using focus groups and a literature review...
February 27, 2018: Pediatric Pulmonology
Gina Hong, Kevin J Psoter, Mark T Jennings, Christian A Merlo, Michael P Boyle, Denis Hadjiliadis, Steven M Kawut, Noah Lechtzin
BACKGROUND: Aspergillus species are increasingly detected in the respiratory tracts of individuals with cystic fibrosis (CF), and chronic Aspergillus fumigatus is associated with more frequent hospitalizations for pulmonary exacerbations. However, patient and clinical factors that may contribute to the acquisition of persistent Aspergillus infection have yet to be identified. The objective of this study was to identify risk factors for development of Aspergillus respiratory isolation in CF...
February 12, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Bryan A Garcia, Jacque L Carden, Dana L Goodwin, Tim A Smith, Amit Gaggar, Kevin Leon, Veena B Antony, Steven M Rowe, George M Solomon
BACKGROUND: Infection with Burkholderia cepacia complex (Bcc) results in a heterogeneous clinical course ranging from asymptomatic colonization of the airways to fulminant respiratory failure in patients with cystic fibrosis (CF). Early eradication of Pseudomonas aeruginosa improves clinical outcomes. The efficacy and clinical outcomes following implementation of an eradication protocol for Bcc are less well understood. METHODS: We developed and implemented a single center Bcc eradication protocol that included an intensive combination of intravenous, inhaled, and oral antibiotic therapies based on in vitro sensitivities...
February 14, 2018: BMC Pulmonary Medicine
Jaime L Hook, Mohammad N Islam, Dane Parker, Alice S Prince, Sunita Bhattacharya, Jahar Bhattacharya
Infection by Staphylococcus aureus strain USA300 causes tissue injury, multiorgan failure, and high mortality. However, the mechanisms by which the bacteria adhere to, then stabilize on, mucosal surfaces before causing injury remain unclear. We addressed these issues through the first real-time determinations of USA300-alveolar interactions in live lungs. We found that within minutes, inhaled USA300 established stable, self-associated microaggregates in niches at curved, but not at flat, regions of the alveolar wall...
February 12, 2018: Journal of Clinical Investigation
William C Anderson, Stanley J Szefler
Strategies to control the risk domain of NHLBI EPR-3 (National Heart, Lung, and Blood Institute Expert Panel Report-3) asthma guidelines, which includes exacerbations requiring systemic corticosteroids, reduction in lung growth, and progressive loss of lung function, and treatment-related adverse effects, are evolving in children and adolescents. Increasing evidence demonstrates that children and adolescents with asthma are at risk of a reduction in lung growth, leading to lower lung function and potentially chronic obstructive pulmonary disease as adults...
February 2018: Seminars in Respiratory and Critical Care Medicine
Ching-Yee Loo, Wing-Hin Lee, Gianluca Lauretani, Santo Scalia, David Cipolla, Daniela Traini, Paul Young, Hui Xin Ong
PURPOSE: The failure of chronic therapy with antibiotics to clear persistent respiratory infection is the key morbidity and mortality factor for patients with chronic lung diseases, primarily due to the presence of biofilm in the lungs. It is hypothesised that carbon sources, such as mannitol, could stimulate the metabolic activity of persister cells within biofilms and restore their susceptibility to antibiotics. The aims of the current study are to: (1) establish a representative in vitro model of Pseudomonas aeruginosa biofilm lung infection, and (2) investigate the effects of nebulised mannitol on antibiotic efficacy, focusing on ciprofloxacin, in the eradication of biofilm...
February 7, 2018: Pharmaceutical Research
Sara I Ruiz, Larry E Bowen, Mark M Bailey, Cory Berkland
Burkholderia pseudomallei, the etiological agent responsible for melioidosis, exhibits a great public health toll in its endemic regions. The elevation of B. pseudomallei to a Tier I select agent underscores the urgent need for effective therapeutics and preventatives. The current treatment regimen for melioidosis is sub-optimal, requiring an intensive phase of intravenous antibiotic followed by months of oral antibiotics. Inhaled antibiotics are a promising avenue to pursue for pulmonary diseases, including melioidosis, since this mode of delivery mimics the likely exposure route and can provide high drug doses directly to the infected tissue...
January 24, 2018: Molecular Pharmaceutics
Roselyn Kellen, Nanette B Silverberg
Periorificial dermatitis (POD) has been documented in the pediatric population in patients as young as 3 months, with a slight predominance in girls compared to boys. Many patients have a personal or family history of atopic disorders. Periorificial dermatitis typically presents with erythematous to flesh-colored papules and rarely pustules near the eyes, nose, and mouth. Although the etiology is unknown, many patients have had recent exposure to a topical or less commonly an inhaled or systemic corticosteroid...
December 2017: Cutis; Cutaneous Medicine for the Practitioner
Leah Lande, Jason George, Theodore Plush
PURPOSE OF REVIEW: The prevalence of Mycobacterium avium complex (MAC)-related pulmonary disease has been increasing because of environmental factors, changes in organism virulence, and evolving host susceptibility. Treatment is often complicated by adverse effects, development of drug resistance, and refractory disease, with recurrence rates as high as 25-45%. RECENT FINDINGS: Aerosolization of water, soil, or dusts are the likely sources of MAC-related pulmonary disease in susceptible individuals...
April 2018: Current Opinion in Infectious Diseases
Cherry O Onaiwu, Manasa Velagapudi, Luay Sarsam, Lindsay Utley, Lauren Bricker, Venkata Sunil Bendi, Renuga Vivekanandan
Nocardiosis is an opportunistic infection in patients with depressed cell-mediated immunity. Inhalation is the primary route for exposure via dust particles. Patients with acquired immune deficiency syndrome (AIDS) are at increased risk of disseminated disease. A challenge in the diagnosis of pulmonary nocardiosis is that it can mimic other pulmonary diseases. Nocardia farcinica tends to be a more virulent, multidrug-resistant strain with an increased tendency to disseminate. This report describes a 64-year-old man with AIDS found to have pulmonary nocardiosis that did not respond to standard antibiotic therapy...
November 11, 2017: Curēus
Sabina Antonela Antoniu
Bronchiectasis not related to cystic fibrosis (non-CF bronchiectasis) are associated with a high unmet therapeutic need due to the lack of specifically authorized medications, especially via the inhalation route. In non-CF bronchiectasis chronic infection with Pseudomonas aeruginosa is common and favored by the persistent local inflammation and viscid sputum production. Therefore inhaled antibiotics, mucolytics or anti-inflammatory agents could represent appropriate therapeutic interventions in this setting Areas covered: This review herein discusses the inhaled therapies currently under investigation for non-CF bronchiectasis and their potential therapeutic positioning in exacerbation versus stable state...
January 17, 2018: Expert Opinion on Investigational Drugs
Qinhua Pu, Jinxian Qian, Weiyi Tao, Aixiang Yang, Jian Wu, Yaodong Wang
RATIONALE: Hydrofluoric acid (HF) is a highly corrosive agent and can cause corrosive burns. HF can penetrate deeply into tissues through intact skin and the lipid barrier, leading to painful liquefactive necrosis, and inducing hypocalcemia and hypomagnesemia. In this study, we hypothesize that continuous renal replacement therapy (CRRT) may be beneficial in addressing hemodynamic instability in cases of HF poisoning. PATIENT CONCERNS: A 25-year-old man fell into an electroplating pool containing 10% HF and 50% nitric acid...
December 2017: Medicine (Baltimore)
Libor Fila
Cystic fibrosis (CF) is an inherited disease caused by mutations in the transmembrane conductance regulator (CFTR) gene. The disease leads to dysfunction of the exocrine glands with high concentration of chloride in the sweat and formation of abnormally viscous mucus in the respiratory, digestive and reproductive tract. Chronic sinopulmonary disease, exocrine pancreatic insufficiency, liver disease, intestinal obstruction, impaired nutritional status, salt loss syndrome and male infertility dominates in the clinical presentation...
2018: Vnitr̆ní Lékar̆ství
M A Ryabova
The present study was carried out based at the Department of Otorhinolaryngology of I.P. Pavlov First State Medical University of Saint-Petersburg. The objective of this work was to elucidate the efficacy and safety of fenspiride therapy for the treatment of exacerbation of chronic laryngitis associated with an acute respiratory infection. The patients comprising the main group received fenspiride (Eurespal, 'Servier', France) at the standard dose in addition to the conventional therapy with the use of antibiotics, inhalation, and voice rest...
2017: Vestnik Otorinolaringologii
Gary T Ferguson, Donald P Tashkin, Tor Skärby, Carin Jorup, Kristina Sandin, Michael Greenwood, Kristine Pemberton, Frank Trudo
BACKGROUND: Prevention of exacerbations is a primary goal for chronic obstructive pulmonary disease (COPD) therapy. This randomized, double-blind, double-dummy, parallel-group, multicenter study evaluated the effect of budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus formoterol dry powder inhaler (DPI) on reducing COPD exacerbations. METHODS: 1219 patients aged ≥40 years with moderate-to-very-severe COPD (per lung function) and a history of ≥1 COPD exacerbation received budesonide/formoterol pMDI 320/9 μg twice daily (BID) during a 4-week run-in...
November 2017: Respiratory Medicine
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