title: Combinations of colistin solutions and nebulisers for lung infection management in cystic fibrosis patients.
abstract: In this work different nebulisers were investigated in order to assess their efficiency in combination with colistimethate sodium (CMS) inhalation products. Four nebulisers, namely I-neb(®), Aeroneb(®) Go, eFlow(®)rapid and PARI LC(®) Sprint were studied in terms of delivered dose (DD), drug delivery rate (DDR) and respirable dose (RD) of CMS. The goal was to provide scientific data to physicians for prescribing the most appropriate nebuliser for the CMS specific user. All the apparatuses nebulised ColiFin 1MIU/3 ml solution (80 mg of CMS) with delivered doses between 31% and 41% of the loaded amount. Aeroneb Go showed the longest nebulisation time (more than 20 min). When ColiFin 2 MIU/4 ml was nebulised with eFlow rapid or PARI LC Sprint, the CMS respirable dose was 45.3mg and 39.2mg, in times of 5.6 and 10.8 min, respectively. I-neb, having a medication cup capacity limited to 0.4 ml, loaded with Promixin 0.4 MIU/0.4 ml (32 mg of CMS), provided in a time of 9 min a RD of 21.5mg, a value slightly higher than those obtained by nebulising ColiFin 1 MIU/3 ml with the other nebulisers (range 15.9-17.6 mg). The results illustrate that the clinical outcome depends on the comparative analysis of nebulisation efficiency (respirable dose) and convenience (time), not disregarding the ratios between the amount loaded, delivered and deposited at lung level.
authors: Department of Pharmacy, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy; Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, SE19NH London, United Kingdom. Electronic address: francesca.buttini@unipr.it.
authors: Francesca
authors: F
authors: Buttini
authors: Department of Pharmacy, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy.
authors: Irene
authors: I
authors: Rossi
authors: Interdepartmental Centre, Biopharmanet-TEC, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy.
authors: Marica
authors: M
authors: Di Cuia
authors: Department of Pharmacy, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy.
authors: Alessandra
authors: A
authors: Rossi
authors: Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 17/19, 44121 Ferrara, Italy.
authors: Gaia
authors: G
authors: Colombo
authors: Department of Pharmacy, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy.
authors: Lisa
authors: L
authors: Elviri
authors: Department of Pharmacy, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy.
authors: Fabio
authors: F
authors: Sonvico
authors: Interdepartmental Centre, Biopharmanet-TEC, University of Parma, Viale delle Scienze 27/A, 43124 Parma, Italy.
authors: Anna Giulia
authors: AG
authors: Balducci
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D003091:Colistin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000188:drug therapy; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy; D009330:Nebulizers and Vaporizers; D012996:Solutions
chemical_list: D000900:Anti-Bacterial Agents; D012996:Solutions; C004691:colistinmethanesulfonic acid; D003091:Colistin
keywords: Aerosol; ColiFin; Colistimethate sodium; Jet nebuliser; Membrane nebuliser; Promixin