Generic placeholder image

Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Comparing the Efficacy and Safety of Nebulized Gentamicin Plus Amikacin versus Tobramycin in Patients with Cystic Fibrosis

Author(s): Fatemeh Kouhestani, Maryam Hassanzad* and Shadi Baniasadi*

Volume 19, Issue 1, 2024

Published on: 05 April, 2023

Page: [82 - 87] Pages: 6

DOI: 10.2174/1574886318666230228120550

Price: $65

Abstract

Background: Cystic fibrosis is an autosomal recessive disease that causes respiratory tract infection. These patients use nebulized antibiotics such as tobramycin and gentamicin plus amikacin. Due to the high price of tobramycin and the inaccessibility of this drug in Iran at different periods, we aimed to compare the efficacy and safety of nebulized plus amikacin and tobramycin in patients with cystic fibrosis.

Methods: In this analytic cross-sectional study, data were collected from the records of all patients with cystic fibrosis. They were divided into two groups by their type of nebulized antibiotic. Group 1 included 41 patients who received 80 mg gentamicin and 500 mg amikacin as a nebulized antibiotic every other month, whereas, group 2 consisted of 9 patients who received 300 mg nebulized tobramycin. Collected data were pulmonary function parameters, body mass index, the frequency of hospitalization, infection progress, Shwachman-Kulczycki score, and renal complications. The data were compared in terms of efficacy and renal adverse effects by independent t-test and repeated measure ANOVA.

Results: A total of 50 cystic fibrosis patients were evaluated and there was no significant difference between group 1 and group 2 in terms of pulmonary function, frequency of hospitalizations, body mass index, Shwachman-Kulczycki score, infection progress, and renal complications. Notably, pulmonary function factors were reduced in both groups over time during their treatment.

Conclusion: Nebulized tobramycin and gentamicin plus amikacin had similar efficacy against Pseudomonas aeruginosa in cystic fibrosis and had no serious renal complications.

Keywords: Cystic fibrosis, gentamicin, tobramycin, FEV1, FVC, Pseudomonas aeruginosa.

Graphical Abstract
[1]
Stuart B, Lin JH, Mogayzel PJ Jr. Early eradication of Pseudomonas aeruginosa in patients with cystic fibrosis. Paediatr Respir Rev 2010; 11(3): 177-84.
[http://dx.doi.org/10.1016/j.prrv.2010.05.003] [PMID: 20692633]
[2]
Pamukcu A, Bush A, Buchdahl R. Effects of Pseudomonas aeruginosa colonization on lung function and anthropometric variables in children with cystic fibrosis. Pediatr Pulmonol 1995; 19(1): 10-5.
[http://dx.doi.org/10.1002/ppul.1950190103] [PMID: 7675552]
[3]
Ratjen F, Munck A, Kho P, Angyalosi G. Treatment of early Pseudomonas aeruginosa infection in patients with cystic fibrosis: The ELITE trial. Thorax 2010; 65(4): 286-91.
[http://dx.doi.org/10.1136/thx.2009.121657] [PMID: 19996339]
[4]
Davidson AGF, Chilvers MA, Lillquist YP. Effects of a Pseudomonas aeruginosa eradication policy in a cystic fibrosis clinic. Curr Opin Pulm Med 2012; 18(6): 615-21.
[http://dx.doi.org/10.1097/MCP.0b013e328358f5a2] [PMID: 22990661]
[5]
Akkerman-Nijland AM, Akkerman OW, Grasmeijer F, et al. The pharmacokinetics of antibiotics in cystic fibrosis. Expert Opin Drug Metab Toxicol 2021; 17(1): 53-68.
[http://dx.doi.org/10.1080/17425255.2021.1836157] [PMID: 33213220]
[6]
Schuster A, Haliburn C, Döring G, Goldman MH. Safety, efficacy and convenience of colistimethate sodium dry powder for inhalation (Colobreathe DPI) in patients with cystic fibrosis: A randomised study. Thorax 2013; 68(4): 344-50.
[http://dx.doi.org/10.1136/thoraxjnl-2012-202059] [PMID: 23135343]
[7]
Vázquez Espinosa E, Giron RM, Gómez Punter RM, et al. Long-term safety and efficacy of tobramycin in the management of cystic fibrosis. Ther Clin Risk Manag 2015; 11: 407-15.
[http://dx.doi.org/10.2147/TCRM.S75208] [PMID: 25792839]
[8]
Lenoir G, Antypkin YG, Miano A, et al. Efficacy, safety, and local pharmacokinetics of highly concentrated nebulized tobramycin in patients with cystic fibrosis colonized with Pseudomonas aeruginosa. Paediatr Drugs 2007; 9(1 Suppl 1): 11-20.
[http://dx.doi.org/10.2165/00148581-200709001-00003] [PMID: 17536871]
[9]
Proesmans M, Vermeulen F, Boulanger L, Verhaegen J, De Boeck K. Comparison of two treatment regimens for eradication of Pseudomonas aeruginosa infection in children with cystic fibrosis. J Cyst Fibros 2013; 12(1): 29-34.
[http://dx.doi.org/10.1016/j.jcf.2012.06.001] [PMID: 22762867]
[10]
Elson EC, Mermis J, Polineni D, et al. Aztreonam lysine inhalation solution in cystic fibrosis. Circulatory, respiratory and pulmonary medicine is. Clin Med 2019; 13: 1179548419842822.
[11]
Bilton D, Fajac I, Pressler T, et al. Long-term amikacin liposome inhalation suspension in cystic fibrosis patients with chronic P. aeruginosa infection. J Cyst Fibros 2021; 20(6): 1010-7.
[http://dx.doi.org/10.1016/j.jcf.2021.05.013] [PMID: 34144923]
[12]
Stormbroek BV, Zampoli M, Morrow BM. Nebulized gentamicin in combination with systemic antibiotics for eradicating early Pseudomonas aeruginosa infection in children with cystic fibrosis. Pediatr Pulmonol 2019; 54(4): 393-8.
[http://dx.doi.org/10.1002/ppul.24254] [PMID: 30656856]
[13]
Heinzl B, Eber E, Oberwaldner B, Haas G, Zach MS. Effects of inhaled gentamicin prophylaxis on acquisition of Pseudomonas aeruginosa in children with cystic fibrosis: A pilot study. Pediatr Pulmonol 2002; 33(1): 32-7.
[http://dx.doi.org/10.1002/ppul.10019] [PMID: 11747258]
[14]
Labiris NRC, Holbrook AM, Chrystyn H, MacLeod SM, Newhouse MT. Dry powder versus intravenous and nebulized gentamicin in cystic fibrosis and bronchiectasis. A pilot study. Am J Respir Crit Care Med 1999; 160(5): 1711-6.
[http://dx.doi.org/10.1164/ajrccm.160.5.9810080] [PMID: 10556145]
[15]
Kun P, Landau LI, Phelan PD. Nebulized gentamicin in children and adolescents with cystic fibrosis. J Paediatr Child Health 1984; 20(1): 43-5.
[http://dx.doi.org/10.1111/j.1440-1754.1984.tb00035.x] [PMID: 6466215]
[16]
Martin AJ, Smalley CA, George RH, Healing DE, Anderson CM. Gentamicin and tobramycin compared in the treatment of mucoid pseudomonas lung infections in cystic fibrosis. Arch Dis Child 1980; 55(8): 604-7.
[http://dx.doi.org/10.1136/adc.55.8.604] [PMID: 7436516]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy