Nebulisers comparison with inhaled tobramycin in young children with cystic fibrosis

Abstract

This pilot study shows that evaluation of nebulisers based on tobramycin renal excretion is feasible in young children with cystic fibrosis.

Inhaled Thiamphenicol and Acetilcysteine in Children with Acute Bacterial Rhinopharyngitis

“…As a matter of fact, it allows to achieve higher local drug concentrations, to consequently use lower drug dosage, to exert prompt activity, to remove secretions by the watery solution, to increase tolerability (particularly suitable for children), and to reduce the occurrence of antibiotic resistance. In this regard, several studies highlight the effectiveness of inhaled antibiotics in treating bacterial respiratory infections (7)(8)(9)(10)(11)(12). Very recently, we provided evidence that inhaled tobramycin was more effective than amoxicillin clavulanate in treating children with acute bacterial rhinopharyngitis (13).…”

Lung deposition of inhaled tobramycin with eFlow rapid/LC Plus jet nebuliser in healthy and cystic fibrosis subjects

“…Patient compliance and acceptance of a twicedaily tobramycin regimen may be improved by decreasing the nebulisation time using an alternative drug delivery system [9]. A wide range of commercially available nebulisers have been tested as alternatives to administration of tobramycin [10,11]. The battery-driven eFlow rapid nebuliser (PARI Respiratory Equipment Inc., Midlothian, VA, USA) is designed to deliver liquid or suspension formulations for inhalation more rapidly than the jet nebulisers [8,12].…”

Clinical pharmacology of tobramycin in infants and children

“…Tobramycin is an aminoglycoside antibiotic, is active against gramnegative bacteria, the primary bacterial intracellular site of tobramycin action is the 30S ribosomal subunit, tobramycin binds to polysomes and interferes with bacterial protein synthesis causing misreading, premature termination of mRNA translation causing incorrect amino acids incorporation into growing polypeptide chains, and is bactericidal [4]. Tobramycin may be administered orally, intravenously (either by low injection or intravenously infused), intramuscularly, applied to skin, and by inhalator or nebuliser to treat lung infection [7,10,[15][16][17][18][19]38,39,[42][43][44]55], and nebuliser delivers tobramycin more rapidly [39]. Intravenous tobramycin doses are: 5 mg/kg every 36 hours in infants with a postmenstrual age < 32 weeks, once-daily in older infants [1], and in children these are 2.5 and 3.5 mg/kg given thrice-daily [6].…”

“…Clavel et al [39] compared tobramycin lung absorption; 300 mg of tobramycin was delivered by inhalator or by nebulisation in 10 children, in two separate sessions. The amount tobramycin excretion in the urine was low and variable and accounted for 47.6 mg/g (range, 14.9-79.6) delivered by the nebuliser and 42.6 mg/g (6.3-112.8) by the inhalator.…”