Hepatitis B Virus (HBV)

Tag: pulmonary exacerbations

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Future Studies

Future Studies It is recommended that future studies of aerosolized antibiotics address the following topics: (1) pharmacologic and safety testing of other antipseu-domonal antibiotics alone or in combination; (2) efficacy trials to determine the effect of aerosolized antibiotics when used to treat pulmonary exacerbations; (3) long-term suppression trials to determine if bacteriologic and clinical effect […]

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Microbiological indications

4.    At present, there are no microbiological indications to discontinue treatment with aerosolized antibiotics. The emergence of resistant P aeruginosa or acquisition of intrinsically antibiotic-resistant organisms such as B cepacia and S maltophilia does not preclude the continued use of nebulized agents intermittently (consensus grade II-2). Comment: Several previously published studies have shown transient emergence of resistant P aeruginosa during therapy with aerosolized antibiotics […]

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Recommendations for Addressing Microbiological Implications of Aerosolized Antibiotics

Recommendations for Addressing Microbiological Implications of Aerosolized Antibiotics 1.    It is strongly recommended that all efforts be made to define a breakpoint to correlate in vitro susceptibility with in vivo efficacy for antibiotics delivered by the aerosol route, because at present, there are inadequate data to establish this breakpoint (consensus grade I to III). Comment: The National Committee for Clinical […]

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Emergence of Intrinsically Resistant Pathogens

To define a breakpoint for resistance to aerosolized tobramycin, efforts to correlate the MIC of P aeruginosa isolates and clinical efficacy were made in the preservative-free tobramycin study. There was no significant difference in clinical response among patients with isolates with MICs < vs > 64 ^g/mL. Unfortunately, too few patients had high-level resistance (defined […]

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Receiving Aerosolized Antibiotics

What Are the Microbiological Implications of Aerosolized Antibiotics? There is understandable concern that prolonged use of aerosolized antibiotics could lead to the development of significant antibiotic resistance in P aeruginosa and that intrinsically resistant bacterial and fungal pathogens could emerge during therapy. Development of Resistance in P aeruginosa While Receiving Aerosolized Antibiotics Several studies of antibiotic resistance […]

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Recommendations for Monitoring CF Patients Receiving Aerosolized Antibiotics

4.    Monitoring for eighth nerve toxicity should include an audiogram (500 to 8,000 Hz range) after two to four courses of IV therapy or 180 accumulated days of aerosol therapy (consensus grade III). 5.    The initial dose of a newly prescribed aerosolized antibiotic should be given in the presence of an appropriately trained health-care provider […]

Use of Aerosolized Antibiotics in Patients With Cystic Fibrosis: Safety of Colistin

Safety of Colistin Both nephrotoxicity and neurotoxicity have been documented with IV use of colistin. Signs and symptoms of neurotoxicity include dizziness, numbness and paresthesias (perioral), nausea, vomiting, muscle weakness, and peripheral neuropathy that can progress to confusion and seizures. Such symptoms have not been described with aerosolized colistin, but relatively small numbers of patients […]

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