Nebulisers comparison with inhaled tobramycin in young children with cystic fibrosis.
BACKGROUND
This randomised cross-over pilot study was undertaken in 10 cystic fibrosis children aged 10 to 63 months to describe lung absorption of tobramycin delivered by the PariLC+/PariTurboboyN (Pari GmbH) and the disposable NL9M/AtomisorBoxPlus (Diffusion Technique Française) nebulising systems.


METHODS
Each child inhaled 300 mg tobramycin delivered with one or the other apparatus via a facemask in two separate and standardised sessions. Urine was collected for 6 h. Tobramycin concentrations determined by immunoprecipitation were expressed in mg per g of creatinine and compared by a Wilcoxon test for matched pairs. The influences of age, weight and Brasfield score on this parameter were evaluated by correlation tests, and those of sex, previous nebulisation treatment, and crying or coughing were evaluated by Student's t-test.


RESULTS
The amount of tobramycin measured in urines was low and variable. Median values for urinary tobramycin concentration were 47.6 mg/g (14.9-79.6) with the PariLC+ and 42.6 mg/g (6.3-112.8) with the NL9M (p=0.6). PariLC+ delivered tobramycin in 22 min and NL9M in 12 min (p=0.005). Crying or coughing dramatically reduced the amount of tobramycin collected.


CONCLUSIONS
This pilot study shows that evaluation of nebulisers based on tobramycin renal excretion is feasible in young children with cystic fibrosis.
Clavel
Aurélie
A
Department of Pediatrics, Timone University Pediatric Hospital, Marseille, France.
Boulaméry
Audrey
A
Bosdure
Emmanuelle
E
Luc
Caroline
C
Lanteaume
André
A
Gorincour
Guillaume
G
Stremler-Lebel
Nathalie
N
Sarles
Jacques
J
Andrieu
Véronique
V
Dubus
Jean-Christophe
JC
D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000652:urine; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009330:Nebulizers and Vaporizers; D010865:Pilot Projects; D014031:Tobramycin / Q000008:administration & dosage* / Q000652:urine
D000900:Anti-Bacterial Agents; D014031:Tobramycin