[Nebulized colistin versus tobramycin in the treatment of chronic Pseudomonas colonization in cystic fibrosis patients].
OBJECTIVE
To compare the efficacy, safety and treatment satisfaction with inhaled colistin versus tobramycin in the cure of chronic Pseudomonas colonization in cystic fibrosis patients.


METHODS
A quasi-experimental open paired data trial in which patients with cystic fibrosis and chronic colonization by Pseudomonas aeruginosa were included. Patients performed 2 periods of 6 consecutive months of nebulized antibiotics: inhaled tobramycin at a dose of 300 mg/12 h (Pari LC Plus(®)) and colistimethate (I-neb(®)) at a dose of 1 MIU twice a day. Visits were made monthly and at the beginning and the end of each period; we evaluated the body mass index, lung function, number of exacerbations and sputum microbiology. Patient satisfaction was assessed with 2 questionnaires of satisfaction on the treatment and the inhalation devices.


RESULTS
A group of 25 patients (8 men and 6 under 14 years) with a mean age of 21.4 (7.2) years and 59.8 (21.1) % of forced expiratory volume in one second (FEV1) were included. During the second period, clinical benefits were obtained in terms of lung function with an FEV1 gain of 5% at 6 months of treatment and reducing the number of exacerbations (1.84 [1.2] vs 0.8 [0.8]; P=.001). The questionnaire score was higher in period 2.


CONCLUSIONS
Colistimethate sodium administered through the misting system I-neb(®) provides clinical benefits in terms of exacerbations and improvement of lung function and patient satisfaction for the nebulized antibiotic treatment.
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Investigación Biomédica de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España. Electronic address: esther.quintana@telefonica.net.
Esther
E
Quintana-Gallego
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Investigación Biomédica de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
Jose Luis
JL
Lopez-Campos
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Investigación Biomédica de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
Carmen
C
Calero
Servicio de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, España.
Francisco Javier
FJ
Dapena
D000280:Administration, Inhalation; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003091:Colistin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000382:microbiology*; D008297:Male; D009330:Nebulizers and Vaporizers; D017060:Patient Satisfaction; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D013183:Sputum / Q000382:microbiology*; D011795:Surveys and Questionnaires; D014031:Tobramycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
C004691:colistinmethanesulfonic acid; D014031:Tobramycin; D003091:Colistin
Colistin; Colistina; Cystic fibrosis; Exacerbaciones; Exacerbations; Fibrosis quística; I-neb(®); Jet nebulizers; Nebulizadores jet; Satisfacción; Satisfaction; Tobramicina; Tobramycin