Scripties UMCG - Rijksuniversiteit Groningen
 
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Eradication of Pseudomonas aeruginosa with inhalation of dry powder tobramycin in patients with cystic fibrosis. A retrospective cohort study.

(2018) Yousofi, M. (Mina)

Introduction: In patients with cystic fibrosis, Pseudomonas aeruginosa in the endobronchial airways is the predominant pathogen and its presence is an unfavourable prognostic indicator. Early eradication of P. aeruginosa with inhaled antibiotics via wet nebulizer reduces average decline in lung function, however overall management of the disease can be burdensome. More recently, dry powder tobramycin has become available, providing more convenience and reducing administration time, potentially leading to increased adherence to treatment and subsequently improved clinical outcome.
Objective: To evaluate if dry powder tobramycin is as equally effective in eradicating early P. aeruginosa as treatment with nebulized tobramycin.
Method: A retrospective cohort study. The primary outcome measure was P. aeruginosa eradication by analysing sputum cultures recorded in the patients’ electronic files, where successful eradication was defined as at least two consecutive negative sputum cultures after treatment.
Results: Of the 138 patients with cystic fibrosis, 44 patients were eligible for inclusion. Thirty-one P. aeruginosa infections were found. Analysing the individual cases suggests that treatment via dry powder tobramycin is as equally effective as treatment via wet nebulization. No significant difference was found between the treatment effectiveness in both groups (p=0,110), possibly due to the small patient population size. No side effects or adverse events were recorded.
Conclusion: Patient population size was too small to deliver statistically significant results. Regardless, the results seem promising. A multicentre randomized controlled trial is needed to further investigate the effectiveness of powder tobramycin in the eradication of early P. aeruginosa.






 
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