BACKGROUND: Pseudomonas aeruginosa is the most common pathogenic bacteria in bronchiectasis (BE) patients. The availability and security of nebulized amikacin treatment are unknown. OBJECTIVE: The purpose of this study was to explore the efficiency and adverse effects of nebulized amikacin treatment for 2 weeks, administered as intravenous therapy during exacerbation of BE patients infected with P. aeruginosa. METHODS: A total of 143 patients with exacerbation of BE were screened between January 2013 and March 2016 at five tertiary hospitals in Shandong Province, China. The BE patients were diagnosed by high-resolution computed tomography scans, and all of them were confirmed to be infected with P. aeruginosa after sputum culture test. Seventy-four patients were assigned to the intervention group and received amikacin nebulization (0.2 g) treatment twice daily for 2 weeks along with intravenous antibiotic therapy. Sixty-nine patients were assigned to the control group and received standard antibiotic therapy alone. The primary outcome was the rate of bacterial eradication from the sputum, and the secondary outcomes were drug resistance and adverse effects. RESULTS: The bacterial eradication rate of sputum in the intervention group (51.4%) was significantly higher compared to that in the control group (23.2%) (χ2 = 14.211, p = 0.030). Drug sensitivity testing showed that there were 5 drug-resistant cases in the intervention group and 7 in the control group, which was not significantly different. Three patients dropped out of the trial due to adverse effects. None of the patients hat renal injury. CONCLUSIONS:Nebulized amikacin treatment is a safe treatment for exacerbation of BE and significantly increases the bacterial eradication rate of sputum.
RCT Entities:
BACKGROUND:Pseudomonas aeruginosa is the most common pathogenic bacteria in bronchiectasis (BE) patients. The availability and security of nebulized amikacin treatment are unknown. OBJECTIVE: The purpose of this study was to explore the efficiency and adverse effects of nebulized amikacin treatment for 2 weeks, administered as intravenous therapy during exacerbation of BE patients infected with P. aeruginosa. METHODS: A total of 143 patients with exacerbation of BE were screened between January 2013 and March 2016 at five tertiary hospitals in Shandong Province, China. The BE patients were diagnosed by high-resolution computed tomography scans, and all of them were confirmed to be infected with P. aeruginosa after sputum culture test. Seventy-four patients were assigned to the intervention group and received amikacin nebulization (0.2 g) treatment twice daily for 2 weeks along with intravenous antibiotic therapy. Sixty-nine patients were assigned to the control group and received standard antibiotic therapy alone. The primary outcome was the rate of bacterial eradication from the sputum, and the secondary outcomes were drug resistance and adverse effects. RESULTS: The bacterial eradication rate of sputum in the intervention group (51.4%) was significantly higher compared to that in the control group (23.2%) (χ2 = 14.211, p = 0.030). Drug sensitivity testing showed that there were 5 drug-resistant cases in the intervention group and 7 in the control group, which was not significantly different. Three patients dropped out of the trial due to adverse effects. None of the patients hat renal injury. CONCLUSIONS: Nebulized amikacin treatment is a safe treatment for exacerbation of BE and significantly increases the bacterial eradication rate of sputum.
Authors: Mônica Corso Pereira; Rodrigo Abensur Athanazio; Paulo de Tarso Roth Dalcin; Mara Rúbia Fernandes de Figueiredo; Mauro Gomes; Clarice Guimarães de Freitas; Fernando Ludgren; Ilma Aparecida Paschoal; Samia Zahi Rached; Rosemeri Maurici Journal: J Bras Pneumol Date: 2019-08-12 Impact factor: 2.624
Authors: Sofia Tejada; Sergio Ramírez-Estrada; Carlos G Forero; Miguel Gallego; Joan B Soriano; Pablo A Cardinal-Fernández; Stephan Ehrmann; Jordi Rello Journal: Antibiotics (Basel) Date: 2022-02-19
Authors: Rebecca H McLeese; Arietta Spinou; Zina Alfahl; Michail Tsagris; J Stuart Elborn; James D Chalmers; Anthony De Soyza; Michael R Loebinger; Surinder S Birring; Konstantinos C Fragkos; Robert Wilson; Katherine O'Neill; Judy M Bradley Journal: Eur Respir J Date: 2021-11-11 Impact factor: 16.671