scholarly journals Inhaled Dry Powder Antibiotics in Patients with Non-Cystic Fibrosis Bronchiectasis: Efficacy and Safety in a Real-Life Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2317
Author(s):  
Miguel Ángel Martínez-García ◽  
Grace Oscullo ◽  
Esther Barreiro ◽  
Selene Cuenca ◽  
Angela Cervera ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Real Life ◽  
Common Adverse Effect ◽  
Common Side Effect ◽  
Chronic Obstructive ◽  
Efficacy And Safety ◽  
Dry Powder ◽  
Multi Centre Study ◽  
Life Study ◽  
Inhaled Antibiotics

Background: Nebulised antibiotics are habitually used in patients with bronchiectasis, but the use of dry powder inhaled antibiotics (DPIA) in these patients is extremely limited. This study seeks to analyse the efficacy and safety of DPIA in bronchiectasis patients. Material and methods: Multi-centre study of historic cohorts. All the hospital centres in Spain were contacted in order to collect data on patients with a diagnosis of bronchiectasis who had taken at least one dose of DPIA. Its efficacy was analysed in clinical, functional and microbiological terms by comparing the year before and the year after the prescription of DPIA. Adverse effects and variables associated with these effects, or any need to withdraw the drug, were also analysed. Results: 164 patients from 33 Spanish centres were included; 86% and 14% of these were treated with dry powder colistin and tobramycin, respectively. Chronic bronchial infection by Pseudomonas aeruginosa was present in 86% of these patients, and DPIA significantly reduced the number of exacerbations, the quantity and purulence of sputum and the isolation of pathogenic microorganisms. The most common adverse effect was cough (40%), particularly in cases of Chronic Obstructive Pulmonary Disease (COPD) and a previous cough and in those patients who had difficulties in handling the device. These factors were associated with a higher level of withdrawal of the treatment. There were no serious adverse effects. Conclusions: Our study suggests that DPIA are clinically efficacious and safe for treating bronchiectasis patients. Cough was shown to be the most common side-effect and reason for withdrawal of the treatment.

Levofloxacin for NIH Category II Chronic Bacterial Prostatitis: A Real-Life Study

Chemotherapy ◽  
2019 ◽  
Vol 64 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Vittorio Magri ◽  
Gianpaolo Perletti ◽  
Tommaso Cai ◽  
Konstantinos Stamatiou ◽  
Alberto Trinchieri ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Single Agent ◽  
Real Life ◽  
Symptom Index ◽  
Life Study ◽  
Treatment Groups ◽  
Urogenital Infections ◽  
Real Life Setting ◽  
Urological Procedures ◽  
Clinical Records

Background: Mounting worldwide resistance trends make the use of fluoroquinolone (FQ) antibacterial agents increasingly difficult. This is felt more acutely in the case of urogenital infections, which are mainly caused by Gram-negative pathogens. For years, levofloxacin and other FQs have been the first-line drugs for treating National Institutes of Health (NIH) category II chronic bacteria prostatitis (CBP). Eradication rates achieved by levofloxacin in the frame of randomized trials vary greatly, ranging between 71 and 86%. Objectives: This was a retrospective observational study to investigate the efficacy of levofloxacin against CBP in a real-life setting (urological outpatient wards). Methods: A database including the clinical records of >2,500 CBP patients was reviewed. Patients were selected based on strict inclusion criteria. They were treated for 4 weeks with 500 mg levofloxacin per day, alone or combined with other antibacterials. Besides standard urological procedures including the 4-glass test for pathogen isolation, international symptom questionnaires (the NIH Chronic Prostatitis Symptom Index [NIH-CPSI] and International Prostate Symptom Score [IPSS]) were administered. Results: Pathogen eradication was achieved in 79% of the cases treated with levofloxacin as a single agent and 87.8% of patients who received a combination of levofloxacin and azithromycin. The 11% increase in the eradication rate in the latter group is statistically significant. In addition, the levofloxacin-azithromycin combination caused a significant decrease in prostate volume and significantly increased the bladder-voided volume. IPSS and NIH-CPSI values and the urinary peak flow rate decreased to a similar extent in both treatment groups. No adverse effects were reported by patients belonging to either treatment group. Conclusion: Levofloxacin retained its therapeutic efficacy in patients assessed in a real-life setting, and high eradication rates were attained when it was administered as a single agent. A combination of an FQ with azithromycin induced a significant improvement of eradication rates. This strategy may be an interesting option in both first-referral and relapsing cases, although caution should be exercised when patients are at risk of developing arrhythmias, tendinitis, or other adverse effects.

scholarly journals The Importance of Inhaler Adherence to Prevent COPD Exacerbations

2019 ◽  
Vol 7 (4) ◽  
pp. 54 ◽  
Author(s):  
Jose R Jardim ◽  
Oliver A. Nascimento
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Latin American ◽  
Real Life ◽  
Chronic Obstructive ◽  
Good Adherence ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Life Study ◽  
Copd Exacerbations

It has been shown that the better outcomes of chronic obstructive pulmonary disease (COPD) are closely associated with adherence to drug therapy, independent of the treatment administered. The clinical trial Towards a Revolution in COPD Health (TORCH) study clearly showed in a three year follow up that patients with good adherence to their inhaler treatment presented a longer time before the first exacerbation, a lower susceptibility to exacerbation and lower all-cause mortality. The Latin American Study of 24-hour Symptoms in Chronic Obstructive Pulmonary Disease (LASSYC), a real-life study, evaluated the self-reported inhaler adherence in COPD patients in seven countries in a cross-sectional non-interventional study and found that approximately 50% of the patients had good adherence, 30% moderate adherence and 20% poor adherence. Adherence to inhaler may be evaluated by the specific inhaler adherence questionnaire, the Test of Adherence to Inhalers (TAI). Several factors may predict the incorrect use of inhalers or adherence in COPD outpatient, including the number of devices and the daily dosing frequency. Ideally, patient education, simplicity of the device operation, the use of just one device for multiple medications and the best adaptation of the patient to the inhaler should guide the physician in prescribing the device.

scholarly journals Disability in Moderate Chronic Obstructive Pulmonary Disease: Prevalence, Burden and Assessment - Results from a Real-Life Study

Respiration ◽  
2015 ◽  
Vol 89 (2) ◽  
pp. 100-106 ◽  
Author(s):  
Fulvio Braido ◽  
Ilaria Baiardini ◽  
Nicola Scichilone ◽  
Claudio Sorino ◽  
Fabiano Di Marco ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Real Life ◽  
Disease Prevalence ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Life Study ◽  
Real Life Study ◽  
Assessment Results

scholarly journals Efficacy and safety of Botulinum toxin A for improving esthetics in facial complex: A systematic review

2021 ◽  
Vol 32 (4) ◽  
pp. 31-44
Author(s):  
Ritu Gangigatti ◽  
Vincent Bennani ◽  
John Aarts ◽  
Joanne Choi ◽  
Paul Brunton
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Adverse Effects ◽  
Botulinum Toxin A ◽  
Meta Analysis ◽  
Common Adverse Effect ◽  
Efficacy And Safety ◽  
Improvement Rate ◽  
Graphical Comparison ◽  
Average Improvement

Abstract Aim: To evaluate efficacy and safety of Botulinum toxinA for improving esthetics in the facial complex and correlating them to the dosage and side effects through a systematic review. Methods: A literature search was performed using PubMed, Medline, Web of Sciences, and Scopus databases. Quality of studies was appraised through the GRADE system. This review follows the ‘Preferred reporting items for systematic review and meta-analysis protocols’ (PRISMA-P) 2015 statement. Efficacy was analyzed through improvement rate and effect sizes. Graphical comparison of efficacy and ocular adverse effects (adverse effects around the eye) at various anatomical locations was made by calculating the average improvement rate and adverse events. Results: Twenty-five studies were included in this systematic review after application of the inclusion criteria. Moderate to severe cases in glabellar, lateral canthal, and forehead regions showed higher improvement rates between 20U to 50U, with an effect lasting up to 120 days. Gender and age seemed to have a direct effect on efficacy. Headaches were the most common adverse effect, followed by injection site bruising; all adverse effects resolved within 3-4 days. Conclusions: Treatment with Botulinum toxinA to enhance esthetics of facial complex is efficient and safe at all recommended dosages. Presence of complexing proteins influenced the efficacy of BoNT-A. undesirable muscular adverse effects around the eyes were more predominant when treating the glabellar region. There was no correlation found between the BoNT-A dosage and side effects, however, an increase in dosage did not always lead to an increase in efficacy.

Efficacy and safety of ranibizumab in diabetic macular edema: real life study

2015 ◽  
Vol 93 ◽  
pp. n/a-n/a
Author(s):  
L. Hrarat ◽  
F. Fajnkuchen ◽  
V. Sarda ◽  
T. Grenet ◽  
S. Buffet ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Real Life ◽  
Efficacy And Safety ◽  
Life Study ◽  
Real Life Study

Long-term efficacy and safety of omalizumab in patients with allergic asthma: A real-life study

2021 ◽  
Vol 42 (3) ◽  
pp. 235-242 ◽  
Author(s):  
Andriana I. Papaioannou ◽  
Myrto Mplizou ◽  
Konstantinos Porpodis ◽  
Evangelia Fouka ◽  
Eleftherios Zervas ◽  
...  
Keyword(s):  
Lung Function ◽  
Adverse Events ◽  
Allergic Asthma ◽  
Asthma Control ◽  
Real Life ◽  
Efficacy And Safety ◽  
Life Study ◽  
Long Term Treatment ◽  
Real Life Study

Background: The efficacy and safety of omalizumab in patients with severe allergic asthma have been established in both randomized controlled trials and real-life studies. Objective: To evaluate the sustained effectiveness and safety of long-term treatment with omalizumab in a real-world setting. Methods: In this retrospective study, we included patients treated with omalizumab for at least 8 years in four asthma clinics in Greece. Pulmonary function, asthma control, oral corticosteroids (OCS) dose, and exacerbations were recorded before treatment, 6 months later, and annually thereafter. Adverse events were also recorded. Results: Forty-five patients (66.7% women), mean ± standard deviation (SD) age 55.3 ± 12.2 years, were included. The duration of treatment with omalizumab was 10.6 ± 1.2 years. The annual exacerbation rate decreased from 4.1 before omalizumab initiation to 1.1 after 1 year of treatment and remained low up to the 8th year of treatment (p < 0.001). From the 19 patients who were receiving OCS at baseline, 21.1% patients discontinued after 6 months, 47.4% were still on OCS after 4 years of therapy, and 31.6% were on OCS after 8 years. With regard to the OCS dose, 36.8% of the patients reduced the dose ≥ 50% after 6 months and 68.4% achieved 50% reduction after 2 years. The mean daily OCS dose before omalizumab initiation was 7.8 mg of prednisolone or the equivalent, reduced to 4.7 mg/day after 6 months, which reached 1.6 mg/day after 8 years (p < 0.001). Treatment with omalizumab resulted in significant improvements of asthma control and lung function. No severe adverse events were reported. Conclusion: In this real-life study, omalizumab resulted in significant and sustained improvements in asthma exacerbations, asthma control, and lung function, and had a steroid sparing effect and a good safety profile.

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