Background: Ventilator-associated pneumonia (VAP) due to Pseudomonas aeruginosa has a high mortality and recurrence rate, especially in patients with acute respiratory distress syndrome (ARDS). Therefore, new therapeutic strategies against severe pneumonia are needed. This study evaluated the efficacy of aerosolized tobramycin for P. aeruginosa VAP in ARDS patients.
Methods: A retrospective analysis was performed on patients who developed VAP caused by P. aeruginosa during the course of ARDS at the intensive care unit (ICU) of Kumamoto University Hospital. Aerosolized tobramycin inhalation solution (TIS) 240 mg was administered daily for 14 days in addition to systemic antibiotics.
Results: A total of 44 patients (TIS group, n = 22; control group, n = 22) were included in the analysis. No significant differences were found between the two groups in terms of clinical characteristics, including acute physiology and chronic health evaluation II score upon ICU admission. The TIS group had significantly lower recurrence of P. aeruginosa VAP (22.7% vs. 52.4%, P = 0.04) and ICU mortality (22.7% vs. 63.6%, P < 0.01) than the control group. Bacterial concentration in tracheal aspirate (mean log 10 cfu/mL ± SD on days 2-5: 1.2 ± 1.3 vs. 5.0 ± 2.3, P < 0.01) decreased more rapidly and markedly in the TIS group compared with the control group.
Conclusion: Aerosolized tobramycin was an effective therapeutic strategy for P. aeruginosa VAP patients with ARDS.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.pupt.2017.04.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Tobramycin nanoformulation for chronic pulmonary infections: From drug product definition to scale-up for preclinical evaluation.
Int J Pharm
January 2025
CIDETEC, Basque Research and Technology Alliance (BRTA), Parque Científico y Tecnológico de Gipuzkoa, Donostia-San Sebastián, Spain; Kusudama Therapeutics SA, Parque Científico y Tecnológico de Gipuzkoa, Donostia-San Sebastián, Spain; Biogipuzkoa Health Research Institute, Group of Innovation, 20014 San Sebastian, Spain.
Cystic fibrosis (CF) is characterized by abnormal mucus hydration due to a defective CF Transmembrane Regulator (CFTR) protein, leading to the production of difficult-to-clear mucus. This causes airflow obstruction, recurrent infections, and respiratory complications. Chronic lung infections are the leading cause of death for CF patients and inhaled tobramycin is the first-in-line antibiotic treatment against these infections, mainly caused by Pseudomonas aeruginosa in adult patients.
View Article and Find Full Text PDFJet versus vibrating mesh nebulizer for tobramycin aerosol in spontaneously breathing children with tracheostomies: A simulation study.
Anaesth Crit Care Pain Med
December 2024
Perioperative Care Program, Perioperative Medicine Team, Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands WA 6009, Perth, Australia; Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Perth, Australia; Institute for Paediatric Perioperative Excellence, The University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Perth, Australia; Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, 15 Hospital Ave, Nedlands WA 6009, Perth, Australia. Electronic address:
Article Synopsis
- Tracheostomy tubes increase the risk of respiratory infections, and initial treatment often involves nebulized tobramycin, but there’s a lack of standardized treatment guidelines.
- A study used a breathing simulator to test how much tobramycin reaches simulated children with tracheostomies, comparing delivery methods and doses for different child weights.
- Results showed that jet nebulizers delivered significantly more tobramycin than vibrating mesh nebulizers, highlighting the need for better dosing strategies and further research on drug delivery efficiency and higher dosages for this patient group.
Inhalable tobramycin EEG powder formulation for treating Pseudomonas aeruginosa-induced lung infection.
Int J Pharm
September 2024
Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA; Department of Ophthalmology, Massey Cancer Center, Center for Pharmaceutical Engineering, and Institute for Structural Biology, Drug Discovery & Development (ISB3D), Virginia Commonwealth University, Richmond, VA, USA. Electronic address:
Pulmonary delivery of antibiotics is an effective strategy in treating bacterial lung infection for cystic fibrosis patients, by achieving high local drug concentrations and reducing overall systemic exposure compared to systemic administration. However, the inherent anatomical lung defense mechanisms, formulation characteristics, and drug-device combination determine the treatment efficacy of the aerosol delivery approach. In this study, we prepared a new tobramycin (Tobi) dry powder aerosol using excipient enhanced growth (EEG) technology and evaluated the in vitro and in vivo aerosol performance.
View Article and Find Full Text PDFNanoparticles in liposomes: a platform for increased antibiotic selectivity in multidrug resistant bacteria in respiratory tract infections.
Drug Deliv Transl Res
July 2024
Department of Pharmaceutical Technology, Faculty of Pharmacy & Biotechnology, the German University in Cairo, Cairo, Egypt.
Antibiotic resistance is a cause of serious illness and death, originating often from insufficient permeability into gram-negative bacteria. Nanoparticles (NP) can increase antibiotic delivery in bacterial cells, however, may as well increase internalization in mammalian cells and toxicity. In this work, NP in liposome (NP-Lip) formulations were used to enhance the selectivity of the antibiotics (3C and tobramycin) and quorum sensing inhibitor (HIPS-1635) towards Pseudomonas aeruginosa by fusing with bacterial outer membranes and reducing uptake in mammalian cells due to their larger size.
View Article and Find Full Text PDFDual tobramycin and docosahexaenoic acid loaded nanoemulsions combating Pseudomonas aeruginosa-induced pulmonary infection.
Colloids Surf B Biointerfaces
October 2024
School of Pharmaceutical Sciences, Sun Yat-Sen University, University Town, Guangzhou 510006, PR China; State Key Laboratory of Anti-Infective Drug Discovery and Development, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, PR China; Guangdong Provincial Key Laboratory of Chiral Molecule and Drug Discovery, Sun Yat-Sen University, University Town, Guangzhou 510006, PR China. Electronic address:
Article Synopsis
- Pseudomonas aeruginosa forms biofilms that are tough to eliminate and can cause severe lung issues due to inflammation and oxidative stress.
- Researchers created oil-in-water nanoemulsions (TD-αT NEs) that encapsulate the antibiotic tobramycin (TOB) to effectively target these bacterial biofilms and reduce lung damage.
- When inhaled, these TD-αT NEs not only significantly decreased lung bacterial counts and inflammation but also protected against oxidative stress, making them a promising treatment for chronic lung infections.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!