title: Nebulisers comparison with inhaled tobramycin in young children with cystic fibrosis.
abstract: 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.
authors.affiliation: Department of Pediatrics, Timone University Pediatric Hospital, Marseille, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Clavel
authors.forename: Audrey
authors.initials: A
authors.lastname: Boulaméry
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Bosdure
authors.forename: Caroline
authors.initials: C
authors.lastname: Luc
authors.forename: André
authors.initials: A
authors.lastname: Lanteaume
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gorincour
authors.forename: Nathalie
authors.initials: N
authors.lastname: Stremler-Lebel
authors.forename: Jacques
authors.initials: J
authors.lastname: Sarles
authors.forename: Véronique
authors.initials: V
authors.lastname: Andrieu
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D014031:Tobramycin