Ventilatory effects of aerosol gentamicin.

Abstract

Dally, M. B., Kurrle, S., and Breslin, A. B. X. (1978). Thorax, 33,[54][55][56] Seven subjects, all from the asthmatic group, developed at least one immediate FEV1 fall of 20% or more. The reactions ranged up to 71% and occurred to both test solutions. There was a trend towards greater reactions to the vehicle. In two subjects pretreatment with salbutamol and sodium cromoglycate did not modify these reactions. In three of the seven, inhalation of 2 ml normal saline produced FEV1 falls of 25% to 30%, but these falls were not as great as each subject's reactions to the test solutions. Skin prick tests using the gentamicin solution were negative in all subjects. These results show that substantial obstructive reactions may occur in some asthmatic subjects after inhalation of gentamicin. The reactions appear to be non-immunological in nature and may be due to an irritant effect of the drug vehicle.

Double-blind study of endotracheal tobramycin in the treatment of gram-negative bacterial pneumonia. The Endotracheal Tobramycin Study Group

“…However, other studies using aerosolized aminoglycosides have failed to define a benefit (17). Additionally, aerosolized antibiotics may be associated with significant bronchospasm (especially in patients with asthma), and locally administered agents may result in higher rates of resistant organisms (2,8).…”

Concentrations of gentamicin in serum and bronchial lavage fluid after intravenous and aerosol administration of gentamicin to horses

“…17,[45][46][47][48] As a result of the inability of aerosol administration to deliver medication to areas of the lungs that are not ventilated, the administration of antimicrobials by inhalation alone is not appropriate when substantial consolidation or parenchymal involvement is evident, but it may be of benefit as an adjunct to oral or parenteral administration. [50][51][52] Bronchial constriction resulting from aerosol administration of aminoglycoside solutions can, however, be attenuated by prior treatment with a β 2 -adrenergic agonist. 8 There are several reports that document the alteration of pulmonary mechanics in humans following aerosol administration of antimicrobials, primarily as the result of bronchoconstriction, and it has been suggested that this is the result of irritation induced by the drug, the drug carrier, or the tonicity of the solution.…”

“…47,49 Aminoglycoside and β-lactam antimicrobials may be inactivated in bronchial secretions, but it is likely that this can be overcome by administration of high concentrations of these antimicrobials. 51,53 Serum concentrations of gentamicin following aerosol administration are primarily the result of pulmonary absorption. [50][51][52] Bronchial constriction resulting from aerosol administration of aminoglycoside solutions can, however, be attenuated by prior treatment with a β 2 -adrenergic agonist.…”

Urinary excretion reflects lung deposition of aminoglycoside aerosols in cystic fibrosis

“…Furthermore, a sulphitefree form of tobramycin was not commercially available in France. All other aminoglycosides, but not the commercially available form of amikacin in France (Amiklin1), contain sulphites that may be responsible for severe allergic side effects [14]. This is particularly important in CF patients who are known to have frequent bronchial hyperreactivity [15] and are at risk of bronchial allergy [16], and this is why the present study was conducted with amikacin.…”