Eradication of Pseudomonas aeruginosa in cystic fibrosis patients with inhalation of dry powder tobramycin

Author:

Akkerman-Nijland Anne M.1ORCID,Yousofi Mina2,Rottier Bart L.34,Van der Vaart Hester2,Burgerhof Johannes G. M.5,Frijlink Henderik W.6,Touw Daan J.47,Koppelman Gerard H.34,Akkerman Onno W.2

Affiliation:

1. Department of Paediatrics, University Medical Centre Groningen, Beatrix Children’s Hospital, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, Groningen, 9713 GZ, the Netherlands

2. Department of Pulmonary Diseases and Tuberculosis, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands

3. Department of Paediatric Pulmonology and Paediatric Allergology, University Medical Centre Groningen, Beatrix Children’s Hospital, University of Groningen, Groningen, the Netherlands

4. University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands

5. Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

6. Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands

7. Department of Clinical Pharmacy & Pharmacology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

Abstract

Background: Pseudomonas aeruginosa ( Pa) is the predominant pulmonary pathogen in patients with cystic fibrosis (CF). Tobramycin nebulization is used for the eradication of Pa infection. Nowadays, tobramycin dry powder inhalation (DPI) is available as well. This study reports the results of eradicating Pa with tobramycin DPI versus nebulization. Methods: Adult CF patients with a Pa isolation between September 2010 and September 2017 from the University Medical Centre Groningen (UMCG), the Netherlands, were included in this retrospective study. Results: In total 27 Pa isolations were recorded. In 13 of these, eradication was attempted with tobramycin, 7 with DPI and 6 with nebulization. DPI eradicated Pa successfully in six isolations (85.7%). Of these, one patient received additional oral ciprofloxacin and one received intravenous ceftazidime. Nebulization eradicated three Pa isolations (50.0%), in two of these, additional oral ciprofloxacin was given. Conclusion: Eradication rates of DPI tobramycin are comparable with those for nebulized tobramycin reported in the literature. This study suggests that DPI tobramycin is an alternative to nebulized tobramycin for eradication of Pa. Trial registration: The Medical Ethics Committee of the UMCG granted a waiver (METC2017-349), as they concluded that this study was not subject to the Medical Research Involving Human Subjects Act. The reviews of this paper are available via the supplemental material section.

Publisher

SAGE Publications

Subject

Pharmacology (medical),Pulmonary and Respiratory Medicine

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