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Inhalated therapy antibiotic

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https://www.readbyqxmd.com/read/28509852/inhaled-antibiotic-therapy-in-chronic-respiratory-diseases
#1
REVIEW
Diego J Maselli, Holly Keyt, Marcos I Restrepo
The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF) and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, Burkholderia species and non-tuberculous Mycobacteria (NTM). These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics...
May 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28495619/the-respire-trials-two-phase-iii-randomized-multicentre-placebo-controlled-trials-of-ciprofloxacin-dry-powder-for-inhalation-ciprofloxacin-dpi-in-non-cystic-fibrosis-bronchiectasis
#2
Timothy Aksamit, Tiemo-Joerg Bandel, Margarita Criollo, Anthony De Soyza, J Stuart Elborn, Elisabeth Operschall, Eva Polverino, Katrin Roth, Kevin L Winthrop, Robert Wilson
The primary goals of long-term disease management in non-cystic fibrosis bronchiectasis (NCFB) are to reduce the number of exacerbations, and improve quality of life. However, currently no therapies are licensed for this. Ciprofloxacin Dry Powder for Inhalation (Ciprofloxacin DPI) has potential to be the first long-term intermittent therapy approved to reduce exacerbations in NCFB patients. The RESPIRE programme consists of two international phase III prospective, parallel-group, randomized, double-blinded, multicentre, placebo-controlled trials of the same design...
May 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28479113/pharmacotherapy-for-non-cystic-fibrosis-bronchiectasis-results-from-an-ntm-info-research-patient-survey-and-the-bronchiectasis-and-ntm-research-registry
#3
E Henkle, T R Aksamit, A F Barker, J R Curtis, C L Daley, M L Daniels, A DiMango, E Eden, K Fennelly, D E Griffith, M Johnson, M R Knowles, A Leitman, P Leitman, E Malanga, M L Metersky, P G Noone, A E O'Donnell, K N Olivier, D Prieto, M Salathe, B Thomashow, G Tino, G Turino, S Wisclenny, K L Winthrop
PURPOSE: Non-cystic fibrosis bronchiectasis ("bronchiectasis") is a chronic inflammatory lung disease often associated with nontuberculous mycobacterium (NTM) infection. Very little data exist to guide bronchiectasis management decisions. We sought to describe patterns of inhaled corticosteroid (ICS) and antibiotic therapy in the U.S. METHODS: We invited 2,000 patients through NTM Info & Research (NTMir) to complete an anonymous electronic survey. We separately queried baseline clinical and laboratory data from the U...
May 4, 2017: Chest
https://www.readbyqxmd.com/read/28478753/antibiotic-prescription-patterns-in-spanish-cystic-fibrosis-patients-results-from-a-national-multicenter-study
#4
Juan de Dios Caballero, Rosa Girón, Rosa Del Campo, Concepción Prados, María-Isabel Barrio, Antonio Salcedo, Rafael Cantón
OBJECTIVE: Information about antibiotic prescription patterns for cystic fibrosis (CF) patients and, specifically, about inhaled treatment strategies for their management is lacking in Spain due to the absence of a national patient registry. In this study we present data about antibiotic prescription in the Spanish CF context that were obtained in a multicenter study, being inhaled treatment strategies the special focus of this work. METHODS: Twenty-four specialized CF units (12 adult, 12 pediatric) from 17 tertiary-care hospitals covering all Spanish Autonomous Communities provided sputa and clinical data from 15 consecutive patients...
May 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28476135/the-effects-of-inhaled-aztreonam-on-the-cystic-fibrosis-lung-microbiome
#5
Alya A Heirali, Matthew L Workentine, Nicole Acosta, Ali Poonja, Douglas G Storey, Ranjani Somayaji, Harvey R Rabin, Fiona J Whelan, Michael G Surette, Michael D Parkins
BACKGROUND: Aztreonam lysine for inhalation (AZLI) is an inhaled antibiotic used to treat chronic Pseudomonas aeruginosa infection in CF. AZLI improves lung function and quality of life, and reduces exacerbations-improvements attributed to its antipseudomonal activity. Given the extremely high aztreonam concentrations achieved in the lower airways by nebulization, we speculate this may extend its spectrum of activity to other organisms. As such, we sought to determine if AZLI affects the CF lung microbiome and whether community constituents can be used to predict treatment responsiveness...
May 5, 2017: Microbiome
https://www.readbyqxmd.com/read/28440853/antibiotic-strategies-for-eradicating-pseudomonas-aeruginosa-in-people-with-cystic-fibrosis
#6
REVIEW
Simon C Langton Hewer, Alan R Smyth
BACKGROUND: Respiratory tract infection with Pseudomonas aeruginosa occurs in most people with cystic fibrosis. Once chronic infection is established, Pseudomonas aeruginosa is virtually impossible to eradicate and is associated with increased mortality and morbidity. Early infection may be easier to eradicate.This is an update of a Cochrane review first published in 2003, and previously updated in 2006, 2009 and 2014. OBJECTIVES: To determine whether antibiotic treatment of early Pseudomonas aeruginosa infection in children and adults with cystic fibrosis eradicates the organism, delays the onset of chronic infection, and results in clinical improvement...
April 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#7
MULTICENTER STUDY
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28394614/a-synthetic-macromolecular-antibiotic-platform-for-inhalable-therapy-against-aerosolized-intracellular-alveolar-infections
#8
Debobrato Das, Jasmin Chen, Selvi Srinivasan, Abby Michelle Kelly, Brian Lee, Hye-Nam Son, Frank Radella, Timothy E West, Daniel M Ratner, Anthony J Convertine, Shawn J Skerrett, Patrick S Stayton
Lung-based intracellular bacterial infections remain one of the most challenging infectious disease settings. For example, the current standard for treating Franciscella tularensis pneumonia (tularemia) relies on prolonged administration of oral and intravenous antibiotics that poorly achieve and sustain pulmonary drug bioavailability. Inhalable antibiotic formulations are approved and in clinical development for upper respiratory infections, but sustained drug dosing from inhaled antibiotics against alveolar intracellular infections remains a current unmet need...
April 10, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28377314/clarithromycin-and-n-acetylcysteine-co-spray-dried-powders-for-pulmonary-drug-delivery-a-focus-on-drug-solubility
#9
Michele Dario Manniello, Pasquale Del Gaudio, Rita P Aquino, Paola Russo
Cystic fibrosis (CF) lungs are usually susceptible to Pseudomonas aeruginosa colonization and this bacterium is resistant to immune system clearance and drug control. Particularly, the biofilm mode of growth protects several microorganisms from host defenses and antibacterial drugs, mainly due to a delayed penetration of the drug through the biofilm matrix. Biofilm, together with lung mucus viscosity and tenacity, reduces, therefore, the effectiveness of conventional antibiotic therapy in CF. The aim of this research was to design and develop a stable, portable, easy to use dry powder inhaler (DPI) for CF patients, able to release directly to the lung an association of macrolide antibiotics (clarithromycin) and a mucolytic agent (N-Acetyl-Cysteine)...
April 1, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28374642/value-of-platelet-count-in-the-early-diagnosis-of-nosocomial-invasive-fungal-infections-in-premature-infants
#10
Yu-Chen Yang, Jian Mao
The aim of this study was to investigate the value of a platelet count (PLT) in the early diagnosis of nosocomial invasive fungal infections in premature infants. Based on clinical diagnosis combined with blood culture results, 72 premature infants of 5354 pediatric patients who were hospitalized in the neonatal ward of our hospital between September 2009 and February 2013 were diagnosed with nosocomial invasive fungal infections (fungal infection group). There were 58 premature infants diagnosed with bacterial infections during the same period (bacterial infection group)...
April 4, 2017: Platelets
https://www.readbyqxmd.com/read/28367654/a-review-of-co-milling-techniques-for-the-production-of-high-dose-dry-powder-inhaler-formulation
#11
Michael Lau, Paul M Young, Daniela Traini
Drug delivery by inhalation offers several advantages compared to other dosage forms, including rapid clinical onset, high bioavailability, and minimal systemic side effects. Drug delivery to the lung can be achieved as liquid suspensions or solutions in nebulizers and pressurized metered-dose inhalers (pMDI), or as dry powders in dry powder inhalers (DPIs). Compared to other delivery systems, DPIs are, in many cases, considered the most convenient as they are breath actuated and do not require the use of propellants...
April 19, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28351789/comparative-effectiveness-of-step-up-therapies-in-children-with-asthma-prescribed-inhaled-corticosteroids-a-historical-cohort-study
#12
Clare S Murray, Mike Thomas, Kathryn Richardson, David B Price, Steve W Turner
BACKGROUND: In children with uncontrolled asthma prescribed low-dose inhaled corticosteroids (ICSs), various step-up options are available: fixed-dose combination ICS/long-acting β2-agonist (FDC), increasing ICS dose, or adding leukotriene receptor antagonist (LTRA). However, evidence of their relative effectiveness is limited. OBJECTIVE: To compare the effectiveness of step-up treatment to FDC in children with asthma versus increased ICS dose, or LTRA. METHODS: This matched cohort study used UK primary-care databases to study children prescribed their first step-up treatment to FDC, increased ICS dose, or LTRA...
March 25, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28337719/an-early-health-economic-analysis-of-the-potential-cost-effectiveness-of-an-adherence-intervention-to-improve-outcomes-for-patients-with-cystic-fibrosis
#13
Paul Tappenden, Susannah Sadler, Martin Wildman
BACKGROUND: Cystic fibrosis (CF) negatively impacts upon health-related quality of life and survival. Adherence to nebulised treatments is low; improving adherence is hypothesised to reduce rates of exacerbation requiring intravenous antibiotics and lung function decline. OBJECTIVE: A state transition model was developed to assess the cost effectiveness of an intervention aimed at increasing patient adherence to nebulised and inhaled antibiotics compared with current CF care, in advance of the forthcoming CFHealthHub randomised controlled trial (RCT)...
March 23, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28324670/relationship-of-antibiotic-treatment-to-recovery-after-acute-fev1-decline-in-children-with-cystic-fibrosis
#14
Wayne J Morgan, Jeffrey S Wagener, David J Pasta, Stefanie J Millar, Donald R VanDevanter, Michael W Konstan
RATIONALE: Children with cystic fibrosis often suffer acute declines in lung function. We previously showed that such declines are not always treated with antibiotics, but did not assess whether treatment improves the likelihood of recovery. OBJECTIVES: To determine whether new antibiotic treatment was associated with recovery from acute FEV1 decline. METHODS: We studied episodes of FEV1 decline (≥10% from baseline) from the Epidemiologic Study of Cystic Fibrosis...
March 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28283793/diagnosis-and-treatment-of-spontaneous-pneumomediastinum-experience-at-a-single-institution-for-10%C3%A2-years
#15
In-Hag Song, Seock Yeol Lee, Seung Jin Lee, Won Suk Choi
OBJECTIVE: The aim of this study was to identify appropriate method of diagnosis and treatment of spontaneous pneumomediastinum (SPM) based on our experience. METHODS: The medical records of patients who were diagnosed with SPM and treated at our hospital between April 2006 and July 2015 were, retrospectively, analyzed. The data included characteristics of the patients, method of diagnosis, treatment and clinical course. RESULTS: Forty-five patients were diagnosed with SPM and treated at our hospital...
May 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28224661/recurrent-obstructive-fibrinous-tracheal-pseudomembranes-in-a-young-english-bulldog
#16
E Robin, L V Guieu, K Le Boedec
Endotracheal intubation is a common procedure, rarely associated with life-threatening complications (e.g., tracheal rupture, necrosis, foreign body). A 1.5-year-old English Bulldog was presented for respiratory distress, with increased respiratory efforts and stridor, 2 days after endotracheal intubation. Cervical and thoracic radiographs disclosed a severe narrowing of the tracheal lumen associated with an intraluminal soft-tissue structure at the thoracic inlet. Tracheoscopy confirmed the presence of an obstructive fibrinous tracheal pseudomembrane (OFTP) creating a 1-way valve obstruction...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28212153/new-therapies-for-the-prevention-and-treatment-of-exacerbations-of-bronchiectasis
#17
Hani Abo-Leyah, James D Chalmers
PURPOSE OF REVIEW: Exacerbations of bronchiectasis have a major impact on quality of life, healthcare costs, and long-term risk of complications. Preventing exacerbations is one of the major goals of treatment. Bronchiectasis is increasingly recognized and the impact of bronchiectasis exacerbations on daily clinical practice is also increasing. RECENT FINDINGS: Preventing bronchiectasis exacerbations are dependent on appropriate risk assessment, identifying the patients at highest risk to rationally target preventive therapies...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28184305/once-daily-aerosolised-tobramycin-in-adult-patients-with-cystic-fibrosis-in-the-management-of-pseudomonas-aeruginosa-chronic-infection
#18
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/28126911/characterization-of-inpatient-cystic-fibrosis-pulmonary-exacerbations
#19
Jonathan D Cogen, Assaf P Oron, Ronald L Gibson, Lucas R Hoffman, Matthew P Kronman, Thida Ong, Margaret Rosenfeld
BACKGROUND AND OBJECTIVES: Pulmonary exacerbations lead to significant morbidity and mortality in patients with cystic fibrosis (CF). National consensus guidelines exist, but few studies report current practice in the treatment and monitoring of pulmonary exacerbations. The goal of this study was to characterize consistency and variability in the inpatient management of CF-related pulmonary exacerbations. We focused on the use of guideline-recommended maintenance therapies, antibiotic selection and treatment regimens, use of systemic corticosteroids, and frequency of lung function testing...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28118241/management-of-preschool-recurrent-wheezing-and-asthma-a-phenotype-based-approach
#20
Avraham Beigelman, Leonard B Bacharier
PURPOSE OF REVIEW: The purpose of this review is to summarize the recent evidence on the management of preschool children with wheezing and asthma, and to propose a phenotype-based approach to the management of these children. RECENT FINDINGS: Recent studies have begun to identify populations of preschool children that are likely to benefit from inhaled corticosteroids (ICS) therapy and defined ICS regimens: daily ICS in preschool children with persistent asthma, and pre-emptive high-dose intermittent ICS among preschool children with intermittent disease reduce the risk of exacerbation...
April 2017: Current Opinion in Allergy and Clinical Immunology
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