title: New insights in the production of aerosol antibiotics. Evaluation of the optimal aerosol production system for ampicillin-sulbactam, meropenem, ceftazidime, cefepime and piperacillin-tazobactam.
abstract: BACKGROUND
  Several aerosol antibiotics are on the market and several others are currently being evaluated. Aim of the study was to evaluate the aerosol droplet size of five different antibiotics for future evaluation as an aerosol administration.
  
  
  METHODS
  The nebulizers Sunmist(®), Maxineb(®) and Invacare(®) were used in combination with four different "small <6 ml" residual cups and two "large <10 ml" with different loadings 2-4-6-8 ml (8 ml only for large residual cups) with five different antibiotic drugs (ampicilln-sulbactam, meropenem, ceftazidime, cefepime and piperacillin-tazobactam). The Mastersizer 2000 (Malvern) was used to evaluate the produced droplet size from each combination
  
  
  RESULTS
  Significant effect on the droplet size produced the different antibiotic (F=96.657, p<0.001) and the residual cup design (F=68.535, p<0.001) but not the different loading amount (p=0.127) and the nebulizer (p=0.715). Interactions effects were found significant only between antibiotic and residual cup (F=16.736, p<0.001). No second order interactions were found statistically significant.
  
  
  CONCLUSIONS
  Our results firstly indicate us indirectly that the chemical formulation of the drug is the main factor affecting the produced droplet size and secondly but closely the residual cup design.
authors.affiliation: Pulmonary Department-Oncology Unit, G. Papanikolaou General Hospital, Aristotle Univesrity of Thessaloniki, Thessaloniki, Greece. pzarog@hotmail.com
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.forename: Christos
authors.initials: C
authors.lastname: Ritzoulis
authors.forename: Dimitris
authors.initials: D
authors.lastname: Petridis
authors.forename: Kaid
authors.initials: K
authors.lastname: Darwiche
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Porpodis
authors.forename: Dionysis
authors.initials: D
authors.lastname: Spyratos
authors.forename: Scott
authors.initials: S
authors.lastname: Parrish
authors.forename: Robert
authors.initials: R
authors.lastname: Browning
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: J Francis
authors.initials: JF
authors.lastname: Turner
authors.forename: Lutz
authors.initials: L
authors.lastname: Freitag
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
mesh_terms: D000336:Aerosols; D000667:Ampicillin / Q000737:chemistry; D000900:Anti-Bacterial Agents / Q000737:chemistry*; D000077723:Cefepime; D002442:Ceftazidime / Q000737:chemistry; D002511:Cephalosporins / Q000737:chemistry; D002626:Chemistry, Pharmaceutical; D004867:Equipment Design; D000077731:Meropenem; D009330:Nebulizers and Vaporizers; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000737:chemistry; D010878:Piperacillin / Q000737:chemistry; D000077725:Piperacillin, Tazobactam Drug Combination; D013407:Sulbactam / Q000737:chemistry; D013845:Thienamycins / Q000737:chemistry
chemical_list: D000336:Aerosols; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D000077725:Piperacillin, Tazobactam Drug Combination; C035444:sultamicillin; D000667:Ampicillin; D000077723:Cefepime; D010397:Penicillanic Acid; D002442:Ceftazidime; D000077731:Meropenem; D013407:Sulbactam; D010878:Piperacillin
keywords: Aerosol; Amikacin (PubChem CID: 37768); Amphotericin B (PubChem CID: 49867934); Antibiotics; Aztreonam (PubChem CID: 5742832); Ciprofloxacin (PubChem CID: 2764); Clindamycin (PubChem CID: 29029); Colistin (PubChem CID: 5311054); Fosfomycin (PubChem CID: 73491); Gentamycin (PubChem CID: 3467); Infection; Levofloxacin (PubChem CID: 149096); Tobramycin (PubChem CID: 36294)