A randomised clinical trial of nebulised tobramycin or colistin in cystic fibrosis

被引:201
作者
Hodson, ME
Gallagher, CG
Govan, JRW
机构
[1] Royal Brompton & Harefield NHS Trust, Dept Cyst Fibrosis, London SW3 6NP, England
[2] St Vincents Univ Hosp, Dublin, Ireland
[3] Univ Edinburgh, Sch Med, Edinburgh, Midlothian, Scotland
关键词
colistin; cystic fibrosis; Pseudomonas aeruginosa; tobramycin;
D O I
10.1183/09031936.02.00248102
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Chronic infection with Pseudomonas aeruginosa is associated with progressive deterioration in lung function in cystic fibrosis (CF) patients. The purpose of this trial was to assess the efficacy and safety of tobramycin nebuliser solution (TNS) and nebutised colistin in CF patients chronically infected with P. aeruginosa. One-hundred and fifteen patients, aged greater than or equal to 6 yrs, were randomised to receive either TNS or colistin, twice daily for 4 weeks. The primary end point was an evaluation of the relative change in lung function from baseline, as measured by forced expiratory volume in one second % predicted. Secondary end points included changes in sputum P. aeruginosa density, tobramycin/colistin minimum inhibitory concentrations and safety assessments. TNS produced a mean 6.7% improvement in lung function (p=0.006), whilst there was no significant improvement in the colistin-treated patients (mean change 0.37%). Both nebulised antibiotic regimens produced a significant decrease in the sputum P. aeruginosa density, and there was no development of highly resistant strains over the course of the study. The safety profile for both nebulised antibiotics was good. Tobramycin nebuliser solution significantly improved lung function of patients with cystic fibrosis chronically infected with Pseudomonas aeruginosa, but colistin did not, in this study of 1-month's duration. Both treatments reduced the bacterial toad.
引用
收藏
页码:658 / 664
页数:7
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