Inhaled antibiotics for long-term therapy in cystic fibrosis

Ryan, Gerard; Singh, Meenu; Dwan, Kerry

doi:10.1002/14651858.cd001021.pub2

Cited by 103 publications

(101 citation statements)

References 87 publications

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“…The treatment of chronic P. aeruginosa infection is based on chronic suppressive antibiotic therapy such as nebulised colistin or tobramycin which stabilise the patient's condition, slowing the decline or improving of respiratory function [16] and reducing IV antibiotic replacements such as dornase alfa and nebulised hypertonic saline are used to promote sputum clearance and also improve lung function and reduce exacerbations [17]. These therapies must be combined with daily airway clearance techniques taught and reviewed by an expert physiotherapist.…”

Section: Lungmentioning

confidence: 99%

Adult cystic fibrosis care in the 21st century

Garattini

Bilton

Cremona

et al. 2015

Monaldi Arch Chest Dis

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Cystic fibrosis (CF) is the most common autosomal recessive inherited disease of Caucasian populations. As a result of a variety of diagnostic and therapeutic strategies there has been a dramatic increase in the life expectancy of patients with CF in the last decades and 50% of patients are now adults. This review will focus on the disease in adults and the provision of appropriate care. The complex care required to improve the survival and quality of life in the adult patients can best be provided in a dedicated adult cystic fibrosis unit. These units currently exist in many European countries, but more are needed in Italy.

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Section: Lungmentioning

confidence: 99%

Adult cystic fibrosis care in the 21st century

Garattini

Bilton

Cremona

et al. 2015

Monaldi Arch Chest Dis

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“…The reaction occurs almost immediately after initiation of inhalation and can extend beyond 30 minutes in some individuals [92,94]. A Cochrane review on long-term inhaled antibiotic therapy identified two placebo-controlled trials on the efficacy of inhaled colistin [102]. The trial with the longest duration (6 months) presents limited detail in the abstract, which is the only form of publication [102].…”

Section: Colistinmentioning

confidence: 99%

“…A Cochrane review on long-term inhaled antibiotic therapy identified two placebo-controlled trials on the efficacy of inhaled colistin [102]. The trial with the longest duration (6 months) presents limited detail in the abstract, which is the only form of publication [102]. The 3-months study by Jensen et al did not demonstrate colistin to cause bronchospasm [91].…”

Section: Colistinmentioning

confidence: 99%

“…Patients receiving hypertonic antibiotic therapy have been shown to have more airway narrowing compared to patients receiving antibiotics with lower tonicity, [10,81,102] although this effect might not always be very pronounced [34,35,88]. For example, Dodd et al found no effect of solution tonicity on the occurrence of BHR related to inhalation of colistin, but they did demonstrate an effect on time to maximum fall in FEV1 [34].…”

Section: Causality Of Bhr Related To Antibioticsmentioning

confidence: 99%

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Bronchial Hyperreactivity Related to Inhalation Therapy in Cystic Fibrosis Patients

Eyns¹

2014

J Pulm Respir Med

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It is presumed that bronchial hyperreactivity (BHR) can occur with any inhaled agent and may be a reason for discontinuation of inhalation therapy in cystic fibrosis (CF) patients. On the other hand, inhalation of antibiotics is being increasingly used to eradicate or treat infections.This review focuses on identifying the mechanisms of BHR for a better understanding of its impact on inhalation treatment. BHR in CF is suggested to be secondary to underlying airway disease (associated to poor pulmonary function, chronic inflammation and aerosol distribution) or to be a separate condition occurring more in CF. Furthermore, certain characteristics of the aerosol solution itself, such as the active molecule, chemical additives and particle size, can cause BHR.Recombinant human DNase (rhDNase), hypertonic saline (HS) and the antibiotics tobramycin, colistin and aztreonam lysine for inhalation (AZLI) are frequently used inhalation drugs in the treatment of CF. Prevalence of BHR related to both short and long-term inhalation of these drugs as reported in the literature was investigated. Acute BHR is documented in up to two thirds of CF patients. Despite the widespread use of rhDNase, HS, tobramycin, colistin and AZLI, only one long-term trial looked for, but did not demonstrate, BHR at the end of the trial period.

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“…Numerous antibiotics have been used to treat CF lung infection with P. aeruginosa, although the aminoglycoside antibiotic tobramycin has most often been used and has been studied the most (Gibson, Burns et al 2003;Ryan, Singh et al 2011). In order to achieve high concentration in the airways, tobramycin and other antibiotics are often inhaled in a nebulized form (Ryan, Singh et al 2011).…”

Section: Antibiotic Treatmentsmentioning

confidence: 99%

Pseudomonas aeruginosa Biofilm Formation in the CF Lung and Its Implications for Therapy

Anderson¹

2012

Cystic Fibrosis - Renewed Hopes Through Research

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Inhaled antibiotics for long-term therapy in cystic fibrosis

Cited by 103 publications

References 87 publications

Adult cystic fibrosis care in the 21st century

Adult cystic fibrosis care in the 21st century

Bronchial Hyperreactivity Related to Inhalation Therapy in Cystic Fibrosis Patients

Pseudomonas aeruginosa Biofilm Formation in the CF Lung and Its Implications for Therapy

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