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Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis.
J Infect Dis. 1999 May; 179(5):1190-6.JI

Abstract

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 microgram/mL to define a new break point on the basis of clinical response.

Authors+Show Affiliations

Division of Infectious Disease, Children's Hospital and Regional Medical Center, 4800 Sand Point Way N.E., CH-32, Seattle, WA 98105, USA. jburns@chmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10191222

Citation

Burns, J L., et al. "Effect of Chronic Intermittent Administration of Inhaled Tobramycin On Respiratory Microbial Flora in Patients With Cystic Fibrosis." The Journal of Infectious Diseases, vol. 179, no. 5, 1999, pp. 1190-6.
Burns JL, Van Dalfsen JM, Shawar RM, et al. Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis. J Infect Dis. 1999;179(5):1190-6.
Burns, J. L., Van Dalfsen, J. M., Shawar, R. M., Otto, K. L., Garber, R. L., Quan, J. M., Montgomery, A. B., Albers, G. M., Ramsey, B. W., & Smith, A. L. (1999). Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis. The Journal of Infectious Diseases, 179(5), 1190-6.
Burns JL, et al. Effect of Chronic Intermittent Administration of Inhaled Tobramycin On Respiratory Microbial Flora in Patients With Cystic Fibrosis. J Infect Dis. 1999;179(5):1190-6. PubMed PMID: 10191222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis. AU - Burns,J L, AU - Van Dalfsen,J M, AU - Shawar,R M, AU - Otto,K L, AU - Garber,R L, AU - Quan,J M, AU - Montgomery,A B, AU - Albers,G M, AU - Ramsey,B W, AU - Smith,A L, PY - 1999/4/7/pubmed PY - 2000/3/21/medline PY - 1999/4/7/entrez SP - 1190 EP - 6 JF - The Journal of infectious diseases JO - J Infect Dis VL - 179 IS - 5 N2 - 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 microgram/mL to define a new break point on the basis of clinical response. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/10191222/Effect_of_chronic_intermittent_administration_of_inhaled_tobramycin_on_respiratory_microbial_flora_in_patients_with_cystic_fibrosis_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/314727 DB - PRIME DP - Unbound Medicine ER -