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Effect of Chronic Intermittent Administration of Inhaled Tobramycin on Respiratory Microbial Flora in Patients with Cystic Fibrosis
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Effect of Chronic Intermittent Administration of Inhaled Tobramycin on Respiratory Microbial Flora in Patients with Cystic Fibrosis
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Effect of Chronic Intermittent Administration of Inhaled Tobramycin on Respiratory Microbial Flora in Patients with Cystic Fibrosis
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Journal Article
Effect of Chronic Intermittent Administration of Inhaled Tobramycin on Respiratory Microbial Flora in Patients with Cystic Fibrosis
1999
Overview
Pseudomonas aeruginosa endobronchial infection causes significant morbidity and mortality among cystic fibrosis patients. Microbiology results from two multicenter, double-blind, placebo-controlled trials of inhaled tobramycin in cystic fibrosis were monitored for longitudinal changes in sputum microbial flora, antibiotic susceptibility, and selection of P. aeruginosa isolates with decreased tobramycin susceptibility. Clinical response was examined to determine whether current susceptibility standards are applicable to aerosolized administration. Treatment with inhaled tobramycin did not increase isolation of Burkholderia cepacia, Stenotrophomonas maltophilia, or Alcaligenes xylosoxidans; however, isolation of Candida albicans and Aspergillus species did increase. Although P. aeruginosa tobramycin susceptibility decreased in the tobramycin group compared with that in the placebo group, there was no evidence of selection for the most resistant isolates to become most prevalent. The definition of resistance for parenteral administration does not apply to inhaled tobramycin: too few patients had P. aeruginosa with a tobramycin MIC ⩾16 µg/mL to define a new break point on the basis of clinical response.
Publisher
The University of Chicago Press,University of Chicago Press,Oxford University Press
Subject
/ Adult
/ Anti-Bacterial Agents - administration & dosage
/ Anti-Bacterial Agents - pharmacology
/ Anti-Bacterial Agents - therapeutic use
/ Antibiotics. Antiinfectious agents. Antiparasitic agents
/ Aspergillus - isolation & purification
/ Bacteria - isolation & purification
/ Biological and medical sciences
/ Candida albicans - drug effects
/ Candida albicans - isolation & purification
/ Child
/ Cystic Fibrosis - microbiology
/ Humans
/ Pharmacology. Drug treatments
/ Placebos
/ Pseudomonas aeruginosa - drug effects
/ Pseudomonas Infections - drug therapy
/ Pseudomonas Infections - microbiology
/ Sputum
