Gentamicin cystic fibrosis

Hodson, M.E., Penketh, A.R. and Batten, J.C. (1981). Aerosol carbenicillin and gentamicin treatment of Pseudomonas aeruginosa infection I patients with cystic fibrosis. Lancet 2 1137-1139. 

Clancy JP et al. Evidence that systemic gentamicin suppresses premature stop mutations in patients with cystic fibrosis. Am J Respir Crit Care Med 2001 163 1683-1692. 

The ease of application, the minimization of systemic side effects, and the increased drug penetration directly into the target region resulted in extensive clinical use of iontophoresis mainly in the transdermal field. This technique has been utilized for administration of local anesthetics [2-5], sweat chloride testing in cystic fibrosis patients by transcutaneous delivery of pilocarpine [6,7], administration of vidarabine to patients with herpes orolabialis [8], fluoride administration to patients with hypersensitive dentin [9,10], and gentamicin delivery for the management of burned ears [11],... 

Getttamidtt. Gentamicin is widely used in the treatment of severe infections. Uses include septicemia, neonatal sepsis, neonatal meningitis, biliary tract infection, pyelonephritis, prostatitis, and endocarditis. Gentamicin is frequently used for empiric therapy in presmned gramnegative bacillary infections before the identification and susceptibility of the causative organism are known. Patients with cystic fibrosis and those in intensive care imits often have Pseudomonas infections and are typically treated with gentamicin. 

Tobramycin is similar to gentamicin it is more active against most strains of Pseudomonas aeruginosa and may be less nephrotoxic. It is commonly administered via a nebulizer for treatment of infective exacerbations of cystic fibrosis caused by pseudomonads or Enlerobacteriaceae. 

Newman et al. evaluated the concentration change using four different jet nebulizers, with a gentamicin solution, which is used to treat patients for cystic fibrosis. The types of nebulizers used were the Bird micronebulizer, DeVilbiss 646, Bard Inspiron mini-neb, and Medic-Aid Upmist. All were operated... 

An adolescent with cystic fibrosis developed renal insufficiency and severe vestibular toxicity after treatment with gentamicin and standard-dose ibuprofen (72). A low intravascular volume was a possible contributing factor. 

Scott CS, Retsch-Bogart GZ, Henry MM. Renal faUnre and vestibnlar toxicity in an adolescent with cystic fibrosis receiving gentamicin and standard-dose ibnprofen. Pediatr Pnhnonol 2001 31(4) 314-16. 

A number of antibiotics have been used as aerosol therapies. Examples include beta lactam agents, polymycin antimicrobials, neomycin, gentamicin, and tobramycin. Many of the early efforts were reported as case studies, and observations and data regarding safety and efficacy were lacking. Controlled clinical trials were not conducted until the middle of the 1980s. More recent evaluations have focused on the role of inhaled tobramycin used as suppressive therapy for cystic fibrosis patients colonized with Pseudomonas aeruginosa. 

Heinzl B, Eber E, Oberwaldner B, Haas G, Zach MS. Effects of inhaled gentamicin prophylaxis on acquisition of Pseudomonas aeruginosa in children with cystic fibrosis a pilot study. Pediatr Pulmonol 33 32-37, 2002. 

Stead RJ, Hodson ME, Batten JC. Inhaled certazidime compared with gentamicin and carbenicillin in older patients with cystic fibrosis infected with Pseudomonas aeruginosa. Br J Dis Chest 81 273-279, 1987. 

Iliwite JS, Gorvoy JD, Smaldone GC. Quantitative deposition of aerosobzed gentamicin in cystic fibrosis. Am Rev Resp Dis 136 1445-1449, 1987. 

Bauer LA, Piecoro JJ, Wilson HD, Blouin RA. Gentamicin and tobramycin pharmacokinetics in patients with cystic fibrosis. Clin Pharm 1983 2 262-264. 

Parry MF, Neu HC, Merlino M, et al. Treatment of pulmonary infections in patients with cystic fibrosis A comparative study of ticarcillin and gentamicin. J Pediatr 1977 90 144-148. 

MacDonald NE, Anas NG, Peterson RG, et al. Renal clearance of gentamicin in cystic fibrosis. J Pediatr 1983 103 985-990. 

No interaction was seen in 10 patients given tobramycin with piperacillin, or in another 10 healthy subjects given once daily gentamicin with piperacillin/tazobactam. Only minimal pharmacokinetic changes were seen in 9 healthy subjects given tobramycin with piperacillin/tazobactam, and 18 cystic fibrosis patients (adults and children) given tobramycin with ticarcillin."... 

Susceptibility factors for the development of ototoxicity in adult patients with cystic fibrosis have been reviewed in a retrospective cohort study in 39 patients, of whom seven had evidence of ototoxicity, four had cochlear toxicity, two had vestibular toxicity and one had evidence of both [8 ]. In a multivariate analysis, ototoxicity was predicted by trough serum concentrations over lOmg/1 for amikacin and over 2 mg/1 for gentamicin and tobramycin (OR=45 95% 0=3.1, 655). 

Aerosol antibiotics in controlled studies improved lung function and reduced the number of acute hospital admissions in patients with cystic fibrosis. Minimal drug hypersensitivity has been reported, and there is no solid evidence that the small increase in resistance to some antibiotics, associated with the use of aerosol antibiotics, is in any way detrimental to the patients (for review, see 161). The drugs used are, for example, tobramycin, carbenicillin, and gentamicin. 

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