engleski

Efficacy of Bramitob on eradication of Ps. aeruginosa (PA)

Since 2007. tobramycin inhalations are available in Croatia. Here we report on first experiences with Bramitob® at our CF unit, University Hospital Center in Zagreb regarding PA colonization. In a 18-month period (Apr.07- Sept.08) 27 of our patients (48.2%) had PA isolation from sputa. They were treated with inhaled tobramycin 300 mg twice daily in 28 days on/off cycles until 2 consecutive PA negative cultures were obtained and were afterwords followed at least 6 months. Regarding microbiological results we divided patients in 3 outcome groups at the end of observation: A 10 patients (37%) remained chronically infected with PA ; B 6 patients (22.2%) were recolonized within 6 months after a negative culture ; C 11 patients (40.8%) had negative cultures for 6 months. These groups differed at the beginning of treatment: A subjects with persistent PA colonization aged 8−25 yrs had initially ↑ count of polymorphonuclear lymphocytes (PMN) >25 in sputa and FEV1 ranged 25.3−80.8%pred. In group B aged 12−21 yrs, the PMN count was 1025 and FEV1 ranged 49.0−78.4%pred. In the best outcome group C subjects aged 2−18 yrs had PMN 0−25 and FEV1 ranged 6080%pred. They had previously 3 positive PA cultures. Treatment was connected with a general decrease in PMN count and a mostly favorable effect on lung function in all groups, but with large variability in responses (N.S.). The primary outcome goal (PA eradication) was archived in younger subjects with low PMN count and a shorter PA colonization (C). For this up to 3 Bramitob® cycles were needed. Data from this small sample speak in favor of early treatment for PA and the importance of regular sputum controls. Patients with persistent/recurrent PA colonization (A, B) benefited mainly from decrease in PMN count.

cystic fibrosis; pseudomonas aeruginosa eradication

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