title: Combination aerosol therapy to treat Burkholderia cepacia complex.
abstract: Burkholderia cepacia infection in cystic fibrosis (CF) patients is associated with significant morbidity and mortality, yet no definitive treatment is currently available. This report describes a new approach to treat B. cepacia infection in CF patients, using a combination of amiloride and tobramycin aerosols. Four adults with the typical clinical syndrome of CF were recruited after repeated positive sputum cultures for B. cepacia. Aerosols of amiloride and tobramycin were given three times daily for 1-6 months, and repeated sputum cultures were collected to assess efficacy. Three of the four patients treated with the combined therapy eradicated B. cepacia from their sputum cultures for at least 2 yrs, and there were no adverse events. This novel combination may provide a new therapeutic option for Burkholderia cepacia infections. Furthermore, the strategy of combining antibiotics with ion transport agents may have ramifications for the treatment of other multi-resistant organisms.
authors.affiliation: University of Sydney, CF Unit, Ludwig Engel Centre for Respiratory Research, Dept of Respiratory Medicine, Westmead Hospital, Westmead, 2145, NSW, Australia. peterm@westgate.wh.usyd.edu.au
authors.forename: P G
authors.initials: PG
authors.lastname: Middleton
authors.forename: T J
authors.initials: TJ
authors.lastname: Kidd
authors.forename: B
authors.initials: B
authors.lastname: Williams
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000584:Amiloride / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019121:Burkholderia Infections / Q000150:complications / Q000188:drug therapy*; D042602:Burkholderia cepacia complex; D003550:Cystic Fibrosis / Q000150:complications; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D026941:Sodium Channel Blockers / Q000008:administration & dosage*; D014031:Tobramycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D026941:Sodium Channel Blockers; D000584:Amiloride; D014031:Tobramycin