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Clinical perspective on aztreonam lysine for inhalation in patients with cystic fibrosis.

Daddario MK, Hagerman JK, Klepser ME - Infect Drug Resist (2010)

Bottom Line: Due to the devastating effects on the pulmonary system, interest abounds in ways to improve antimicrobial delivery to the lungs and to impact clinical patient outcomes positively, whilst minimizing systemic toxicities.Recently, aztreonam lysine for inhalation solution, a new monobactam formulation, was approved by the US Food and Drug Administration for use in a subgroup of CF patients with Pseudomonas aeruginosa to improve respiratory symptoms.The purpose of this review is to present a summary of relevant pharmacologic, microbiologic, and clinical data related to the use of aztreonam lysine for inhalation in patients with CF.

View Article: PubMed Central - PubMed

Affiliation: Spectrum Health, Grand Rapids, Michigan;

ABSTRACT
Progressive obstructive lung disease is a characteristic component of cystic fibrosis (CF). It is the pulmonary manifestations, including obstruction and endobronchial infection, which directly contribute to the premature mortality of patients affected with CF. Due to the devastating effects on the pulmonary system, interest abounds in ways to improve antimicrobial delivery to the lungs and to impact clinical patient outcomes positively, whilst minimizing systemic toxicities. Recently, aztreonam lysine for inhalation solution, a new monobactam formulation, was approved by the US Food and Drug Administration for use in a subgroup of CF patients with Pseudomonas aeruginosa to improve respiratory symptoms. The purpose of this review is to present a summary of relevant pharmacologic, microbiologic, and clinical data related to the use of aztreonam lysine for inhalation in patients with CF.

No MeSH data available.


Related in: MedlinePlus

Median sputum aztreonam lysinate concentrations following nebulized administration of aztreonam to adult patients with cystic fibrosis.31
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f1-idr-3-123: Median sputum aztreonam lysinate concentrations following nebulized administration of aztreonam to adult patients with cystic fibrosis.31

Mentions: Sputum samples were collected from patients at 10 minutes, two hours, and four hours postnebulization of the assigned study dose of aztreonam on study days 0, 1, and 2.31 The median sputum concentrations were highest 10 minutes postnebulization in both the adult and adolescent groups. For adults, the median sputum concentrations at four hours postnebulization were 16 μg/g, 36 μg/g, and 52 μg/g, in the 75 mg, 150 mg, and 225 mg aztreonam groups, respectively (Figure 1). In the adolescent cohort, the median sputum concentrations four hours postnebulization were 2 μg/g, 7 μg/g, and 8 μg/g, in the 75 mg, 150 mg, and 225 mg aztreonam groups, respectively (Figure 2). Aztreonam concentrations in adolescent patients were found to be consistently lower than those in adults. In fact, in contrast with adults, sputum concentrations of aztreonam in the adolescent cohort did not exhibit a dose-related increase at any time point. The authors speculated this finding to be attributable to increased salivary dilution in airway secretions due to milder lung disease, reduced central airway deposition of aztreonam, and increased lung clearance of aztreonam compared with adults. Based on these data, the authors concluded that aztreonam concentrations measured in sputum immediately following single doses of aztreonam lysinate generally exceed the aztreonam MIC90 (32 μg/mL) for P. aeruginosa by at least 10-fold.31


Clinical perspective on aztreonam lysine for inhalation in patients with cystic fibrosis.

Daddario MK, Hagerman JK, Klepser ME - Infect Drug Resist (2010)

Median sputum aztreonam lysinate concentrations following nebulized administration of aztreonam to adult patients with cystic fibrosis.31
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108734&req=5

f1-idr-3-123: Median sputum aztreonam lysinate concentrations following nebulized administration of aztreonam to adult patients with cystic fibrosis.31
Mentions: Sputum samples were collected from patients at 10 minutes, two hours, and four hours postnebulization of the assigned study dose of aztreonam on study days 0, 1, and 2.31 The median sputum concentrations were highest 10 minutes postnebulization in both the adult and adolescent groups. For adults, the median sputum concentrations at four hours postnebulization were 16 μg/g, 36 μg/g, and 52 μg/g, in the 75 mg, 150 mg, and 225 mg aztreonam groups, respectively (Figure 1). In the adolescent cohort, the median sputum concentrations four hours postnebulization were 2 μg/g, 7 μg/g, and 8 μg/g, in the 75 mg, 150 mg, and 225 mg aztreonam groups, respectively (Figure 2). Aztreonam concentrations in adolescent patients were found to be consistently lower than those in adults. In fact, in contrast with adults, sputum concentrations of aztreonam in the adolescent cohort did not exhibit a dose-related increase at any time point. The authors speculated this finding to be attributable to increased salivary dilution in airway secretions due to milder lung disease, reduced central airway deposition of aztreonam, and increased lung clearance of aztreonam compared with adults. Based on these data, the authors concluded that aztreonam concentrations measured in sputum immediately following single doses of aztreonam lysinate generally exceed the aztreonam MIC90 (32 μg/mL) for P. aeruginosa by at least 10-fold.31

Bottom Line: Due to the devastating effects on the pulmonary system, interest abounds in ways to improve antimicrobial delivery to the lungs and to impact clinical patient outcomes positively, whilst minimizing systemic toxicities.Recently, aztreonam lysine for inhalation solution, a new monobactam formulation, was approved by the US Food and Drug Administration for use in a subgroup of CF patients with Pseudomonas aeruginosa to improve respiratory symptoms.The purpose of this review is to present a summary of relevant pharmacologic, microbiologic, and clinical data related to the use of aztreonam lysine for inhalation in patients with CF.

View Article: PubMed Central - PubMed

Affiliation: Spectrum Health, Grand Rapids, Michigan;

ABSTRACT
Progressive obstructive lung disease is a characteristic component of cystic fibrosis (CF). It is the pulmonary manifestations, including obstruction and endobronchial infection, which directly contribute to the premature mortality of patients affected with CF. Due to the devastating effects on the pulmonary system, interest abounds in ways to improve antimicrobial delivery to the lungs and to impact clinical patient outcomes positively, whilst minimizing systemic toxicities. Recently, aztreonam lysine for inhalation solution, a new monobactam formulation, was approved by the US Food and Drug Administration for use in a subgroup of CF patients with Pseudomonas aeruginosa to improve respiratory symptoms. The purpose of this review is to present a summary of relevant pharmacologic, microbiologic, and clinical data related to the use of aztreonam lysine for inhalation in patients with CF.

No MeSH data available.


Related in: MedlinePlus