Efficacy of once‐daily tobramycin monotherapy for acute pulmonary exacerbations of cystic fibrosis: A preliminary study

2001 ◽  
Vol 31 (5) ◽  
pp. 367-376 ◽  
Author(s):  
Vahid Master ◽  
G.W. Roberts ◽  
K.P. Coulthard ◽  
P.A. Baghurst ◽  
A. Martin ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Once Daily ◽  
Preliminary Study ◽  
Pulmonary Exacerbations

scholarly journals National Survey of Extended-Interval Aminoglycoside Dosing in Pediatric Cystic Fibrosis Pulmonary Exacerbations

2011 ◽  
Vol 16 (4) ◽  
pp. 262-269 ◽  
Author(s):  
William A Prescott
Keyword(s):  
Cystic Fibrosis ◽  
Online Survey ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Once Daily ◽  
Adverse Drug Reaction Monitoring ◽  
Survey Response Rate ◽  
Cystic Fibrosis Foundation ◽  
Dosing Strategies ◽  
Pulmonary Exacerbations

OBJECTIVES The Cystic Fibrosis Foundation recently deemed the use of extended-interval dosing (EID) of aminoglycosides acceptable for the treatment of cystic fibrosis (CF) pulmonary exacerbations, but current practices across United States (US) pediatric CF accredited care centers and affiliate programs are unknown. The objectives of this research are to characterize the practice trends, dosing strategies, therapeutic drug monitoring practices, and adverse drug reaction monitoring of EID of aminoglycosides in the treatment of pulmonary exacerbations across US pediatric CF programs. METHODS A 38-question online survey was distributed on behalf of the author by the CF Foundation to all US pediatric CF accredited care centers and affiliate programs. RESULTS Of the 70 participating CF programs (42.2% survey response rate), 94.3% reported using EID of aminoglycosides (as once-daily or twice-daily dosing), whereas 84.3% reported using once-daily EID in their pediatric CF population. The frequency of EID use increased with patient age. Tobramycin dosed 10 mg/kg per day every 24 hours, infused over the course of 30 minutes, in combination with an antipseudomonal beta-lactam, was the most commonly cited regimen. Monitoring of aminoglycoside serum concentrations was reported by 98.5% of programs, with a tobramycin peak of 25 to 30 mg/L and trough of less than 1 mg/L targeted most frequently. Nephrotoxicity was commonly monitored through serum creatinine measurements, whereas ototoxicity was monitored by audiometry in approximately one-half of programs. CONCLUSIONS This study indicates that the use of EID of aminoglycosides across US pediatric CF accredited care centers and affiliate programs is common, particularly among adolescents, with tobramycin being the preferred agent.

scholarly journals Variation in treatment preferences of pulmonary exacerbations among Australian and New Zealand cystic fibrosis physicians

2021 ◽  
Vol 8 (1) ◽  
pp. e000956
Author(s):  
Grace Currie ◽  
Anna Tai ◽  
Tom Snelling ◽  
André Schultz
Keyword(s):  
Cystic Fibrosis ◽  
Clinical Trials ◽  
New Zealand ◽  
Treatment Options ◽  
Early Response ◽  
Treatment Preferences ◽  
Dornase Alfa ◽  
Clinical Scenarios ◽  
Professional Opinion ◽  
Pulmonary Exacerbations

BackgroundDespite advances in cystic fibrosis (CF) management and survival, the optimal treatment of pulmonary exacerbations remains unclear. Understanding the variability in treatment approaches among physicians might help prioritise clinical uncertainties to address through clinical trials.MethodsPhysicians from Australia and New Zealand who care for people with CF were invited to participate in a web survey of treatment preferences for CF pulmonary exacerbations. Six typical clinical scenarios were presented; three to paediatric and another three to adult physicians. For each scenario, physicians were asked to choose treatment options and provide reasons for their choices.ResultsForty-nine CF physicians (31 paediatric and 18 adult medicine) participated; more than half reported 10+ years of experience. There was considerable variation in primary antibiotic selection; none was preferred by more than half of respondents in any scenario. For secondary antibiotic therapy, respondents consistently preferred intravenous tobramycin and a third antibiotic was rarely prescribed, except in one scenario describing an adult patient. Hypertonic saline nebulisation and twice daily chest physiotherapy was preferred in most scenarios while dornase alfa use was more variable. Most CF physicians (>80%) preferred to change therapy if there was no early response. Professional opinion was the most common reason for antibiotic choice.ConclusionsVariation exists among CF physicians in their preferred choice of primary antibiotic and use of dornase alfa. These preferences are driven by professional opinion, possibly reflecting a lack of evidence to base policy recommendations. Evidence from high-quality clinical trials is needed to inform physician decision making.

Antimicrobial Therapy of Pseudomonas Pulmonary Exacerbations in Cystic Fibrosis.

1986 ◽  
Vol 75 (1) ◽  
pp. 128-138 ◽  
Author(s):  
U. B. SCHAAD ◽  
D. DESGRANDCHAMPS ◽  
R. KRAEMER
Keyword(s):  
Cystic Fibrosis ◽  
Antimicrobial Therapy ◽  
Pulmonary Exacerbations

scholarly journals Role of C-reactive protein as a biomarker for prediction of the severity of pulmonary exacerbations in patients with cystic fibrosis

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Rosa Maria Girón-Moreno ◽  
José L Justicia ◽  
Sara Yamamoto ◽  
Claudia Valenzuela ◽  
Carolina Cisneros ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Pulmonary Exacerbations

scholarly journals Effect of pulmonary exacerbations treated with oral antibiotics on clinical outcomes in cystic fibrosis

Thorax ◽  
2016 ◽  
Vol 72 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Sanja Stanojevic ◽  
Alexandra McDonald ◽  
Valerie Waters ◽  
Sarah MacDonald ◽  
Eric Horton ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Clinical Outcomes ◽  
Oral Antibiotics ◽  
Pulmonary Exacerbations

Approach to treating cystic fibrosis pulmonary exacerbations varies widely across us CF care centers

2011 ◽  
Vol 46 (9) ◽  
pp. 870-881 ◽  
Author(s):  
Nathan C. Kraynack ◽  
M. David Gothard ◽  
Lynn M. Falletta ◽  
John T. McBride
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Exacerbations
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