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Aerosol Antibiotic Works for Pseudomonas Aeruginosa in Patients with Cystic Fibrosis

An aerosol antibiotic can be used for maintenance treatment of cystic fibrosis (CF) in patients chronically infected with Pseudomonas aeruginosa.

A new preservative- and sulphate-free formula of tobramycin significantly improves respiratory function as early as the second week of treatment, a study of 520 French CF patients indicates. French researchers say the new formula is designed for diffusion in the bronchioles.

Investigators from Necker-Enfants Malades Hospital in Paris and the American Hospital in Neuilly say the formula also offers optimal patient tolerance.

They suggest nebulisation is useful for administration in CF patients because it delivers antibiotics directly to the endobronchial infection site. Toxicity is decreased because of limited systemic absorption.

Antibiotic concentration in bronchial secretions should be as high as 10 times the minimum inhibiting concentration, they say. This allows penetration, suppresses inhibitory factors and promotes bactericidal effectiveness.

According to the researchers, three antibiotics are commonly used for inhalation: tobramycin, amikacin and colistin (colomycin). Their study compared the recently marketed tobramycin formula in 258 participants against placebo in 262 patients. Treatment included three 28-day cycles separated by 28 days of no treatment.

Respiratory function remained significantly improved in the tobramycin patients from the second week of treatment. This included periods with no treatment.

Investigators found tobramycin patients had a parallel decrease in relative risk of hospitalisation, number of days in hospital and number of days on intravenous anti-pyocyanic therapy.
Pediatric Drugs, 2002; 4: 455-467. "Nebulized Antibiotics in Cystic Fibrosis"

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