Study of efficacy, safety, and patient satisfaction with inhaled tobramycin (Tobramycin-Gobbi) in children with cystic fibrosis and pseudomonas infection







https://doi.org/10.18093/0869-0189-2021-31-2-197-206
- Р Р‡.МессенРТвЂВВВВВВВВжер
- РћРТвЂВВВВВВВВнокласснРСвЂВВВВВВВВРєРСвЂВВВВВВВВ
- LiveJournal
- Telegram
- ВКонтакте
- РЎРєРѕРїРСвЂВВВВВВВВровать ссылку
Full Text:
Abstract
Study of efficacy, safety, and patient satisfaction with inhaled tobramycin (Tobramycin-Gobbi) in children with cystic fibrosis and pseudomonas infection
Aim of the study was to assess efficacy and safety of Tobramycin-Gobbi in CF, as well as the patients’ satisfaction with the treatment.
Methods. 35 children from 6 to 18 years with CF were enrolled in this non-interventional prospective cohort multicenter study. All children had P. aeruginosa in the respiratory tract (newly diagnosed, recurrent, or chronic infection). The children received inhalation treatment with Tobramycin-Gobbi in the following cycles: 28-day treatment/28-day break, for 6 months. The studied parameters included respiratory function, bacterial cultures of the respiratory tract with a bacterial count, growth and body weight, antibiotic therapy for the respiratory episodes. The children and parents filled in a questionnaire “Treatment satisfaction assessment” and assessed their state of health on the visual-analog scale before and after each treatment cycle.
Results. P. aeruginosa was eradicated in 17.7% of cases (6 patients, including 2 newly diagnosed, 3 recurrent infections, and 1 chronic infection), reduced bacterial count, decreased number of courses of antibiotic therapy, improvement of FEV1. Adverse reactions were reported by one patient.
Conclusion. The efficacy, safety, and tolerability of Tobramicine Gobbi were confirmed in the patients with newly diagnosed, recurrent, and chronic infection caused by P. aeruginosa.
About the Authors
E. I. KondratyevaRussian Federation
Elena I. Kondratyeva, Doctor of Medicine, Professor, Head of Research and Clinical Division of Cystic Fibrosis.
ul. Moskvorech’e 1, Moscow, 1115478, Russia; tel.: (495) 111-03-03
A. Yu. Voronkova
Russian Federation
Anna Yu. Voronkova, Candidate of Medicine, Leading Researcher of the Research and Clinical Cystic Fibrosis Department.
ul. Moskvorech’e 1, Moscow, 1115478, Russia; tel.: (495) 111-03-03
S. V. Trishina
Russian Federation
Svetlana V. Trishina, Doctor of Medicine, Professor, Head of the Department of Propedeutics of Pediatrics.
Crimea Republic, bul’var Lenina, 5/7, Simferopol’, 295006, Russia; tel.: 8 (978) 752-89-11
N. S. Snetkova
Russian Federation
Natal’ya S. Snetkova, Candidate of Medicine, Assistant of the Department of Propedeutics of Pediatrics.
Crimea Republic, bul’var Lenina, 5/7, Simferopol’, 295006, Russia; tel.: (978) 890-95-29
T. I. Safonova
Russian Federation
Tat’yana I. Safonova, Head of Pulmonary Department.
644001, ul. Kuybysheva 77, Omsk, 644001, Russia; tel.: (3812) 36-16-36
E. B. Pavlinova
Russian Federation
Elena B. Pavlinova, Doctor of Medicine, Associate Professor, Vice-Rector for Academic Affairs, Head of Hospital Pediatrics Department.
ul. Lenina 12, Omsk, 644099, Russia; tel.: (3812) 36-28-35
M. M. Chepurnaya
Russian Federation
Mariya M. Chepurnaya, Doctor of Medicine, Professor, Head of the Pulmonary Department.
ul. 1st Konnoy Armii 33, Rostov-on-Don, 344029, Russia; tel.: (863) 218-97-90
L. E. Kharakhashyan
Russian Federation
Larisa E. Kharakhashyan, Pediatrician, Head of the Infectious Diseases Department.
ul. 1st Konnoy Armii 33, Rostov-on-Don, 344029, Russia; tel.: (863) 222-65-03
O. I. Golubtsova
Russian Federation
Ol’ga I. Golubtsova, Candidate of Medicine, Head of the Department of Pulmonology and Allergology.
ul. Fedora Gladkova 27, Chuvash Republic, Cheboksary, 428020, Russia; tel.: (8352) 55-01-26
M. A. Skachkova
Russian Federation
Margarita A. Skachkova, Doctor of Medicine, Professor, Head of the Department of Pediatrics (Advanced Course).
ul. M.Gor’kogo, per. Dmitrievskiy 6, Orenburg, 460000, Russia; tel.: (3532) 50-06-06 (add. 830)
Yu. A. Kondakova
Russian Federation
Yulia A. Kondakova, pediatrician, City center of cystic fibrosis.
Krasny Prospekt 3, Novosibirsk, 630007, Russia; tel.: (383) 223-16-94
E. A. Enina
Russian Federation
Elena A. Enina, Candidate of Medicine, Head of the Department of Pulmonology; Associate Professor, Hospital Pediatrics Department.
ul. Semashko 3, Stavropol’, 355029, Russia; ul. Mira 310, Stavropol’, 355017, Russia; tel.: (8652) 35-73-38
E. V. Vodovozova
Russian Federation
Ella V. Vodovozova, Candidate of Medicine, Associate Professor, Head of the Department of Pediatrics (Advanced Course).
ul. Mira 310, Stavropol’, 355017, Russia; tel.: (8652) 35-73-38
References
1. Lee T.W.R., Brownlee K.G., Conway S.P. et al. Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. J. Cyst. Fibros. 2003; 2 (1): 29-34. https://doi.org/10.1016/S1569-1993(02)00141-8.
2. Morton R., Doe S., Banya W. et al. Clinical benefit of continuous nebulised Aztreonam Lysine for Inhalation (AZLI) in adults with cystic fibrosis - a retrospective cohort study. J. Cyst. Fibros. 2017; 16 (Suppl. 1): S55. Available at: https://www.cysticfibrosisjournal.com/article/S1569-1993(17)30340-5/pdf
3. Smyth A.R., Bell S.C., Bojcin S. et al. European Cystic Fibrosis Society Standards of Care: Best Practice guidelines. J. Cyst. Fibros. 2014; 13 (Suppl. 1): S23-42. https://doi.org/10.1016/j.jcf.2014.03.010.
4. Castellani C., Duff A.J.A., Bell S.C. et al. ECFS best practice guidelines: the 2018 revision. J. Cyst. Fibros. 2018; 17 (2): 153-178. https://doi.org/10.1016/j.jcf.2018.02.006.
5. Ratjen F., Munck A., Kho P. et al. Treatment of early Pseudomonas aeruginosa infection in patients with cystic fibrosis: the ELITE trial. Thorax. 2010; 65 (4): 286-291. https://doi.org/10.1136/thx.2009.121657.
6. Taccetti G., Bianchini E., Cariani L. et al. Early antibiotic treatment for Pseudomonas aeruginosa eradication in patients with cystic fibrosis: a randomised multicentre study comparing two different protocols. Thorax. 2012; 67 (10): 853-859. https://doi.org/10.1136/thoraxjnl-2011-200832.
7. Proesmans M., Vermeulen F., Boulanger L. et al. Comparison of two treatment regimens for eradication of Pseudomonas aeruginosa infection in children with cystic fibrosis. J. Cyst. Fibros. 2013; 12 (1): 29-34. https://doi.org/10.1016/j.jcf.2012.06.001.
8. Döring G., Flume P., Heijerman H. et al. Treatment of lung infection in patients with cystic fibrosis: current and future strategies. J. Cyst. Fibros. 2012; 11 (6): 461-479. https://doi.org/10.1016/j.jcf.2012.10.004.
9. Smith S., Rowbotham N.J., Regan K.H. Inhaled anti- pseudomonal antibiotics for long-term therapy in cystic fibrosis. Cochrane Database Syst. Rev. 2018; (3): CD001021. https://doi.org/10.1002/14651858.CD001021.pub3.
10. Pierart F. [TOBI Podhaler for treating chronic Pseudomonas aeruginosa infection in cystic fibrosis patients]. Rev. Med. Liege. 2013; 68 (9): 486-488 (in French).
11. Hodson M.E., Gallagher C.G., Govan J.R.W. A randomised clinical trial of nebulised tobramycin or colistin in cystic fibrosis. Eur. Respir. J. 2002; 20 (3): 658-664. https://doi.org/10.1183/09031936.02.00248102.
12. Chuchalin A., Csiszér, E., Gyurkovics K. et al. A formulation of aerosolized tobramycin (Bramitob®) in the treatment of patients with cystic fibrosis and Pseudomonas aeruginosa infection: a double-blind, placebo- controlled, multicenter study. Pediatr. Drugs. 2007; 9 (Suppl. 1): 21-31. https://doi.org/10.2165/00148581-200709001-00004.
13. Konstan M.W., Flume P.A., Keppler M. et al. Safety, efficacy and convenience of tobramycin inhalation powder in cystic fibrosis patients: the EAGER trial. J. Cyst. Fibros. 2011; 10 (1): 54-61. https://doi.org/10.1016/j.jcf.2010.10.003.
14. Pisarev V.V. [Comparison of antibacterial activities of tobramycin inhalation solutions]. Antibiotiki i khimioterapiya. 2013; 58 (3-4): 19-21. Available at: https://www.antibiotics-chemotherapy.ru/jour/article/view/478/478 (in Russian).
15. Gorinova Yu.V., Simonova O. I., Lazareva A. V. et al. [Experience of long-term use of tobramycin solution inhalations in chronic Pseudomonas aeruginosa infection in children with cystic fibrosis]. Rossiyskiy pediatricheskiy zhurnal. 2015; 18, (3): 50-53. Available at: https://cyberleninka.ru/article/n/opyt-dlitelnogo-primeneniya-ingalyatsiy-rastvora-tobramitsina-pri-hronicheskoy-sinegnoynoy-infektsii-u-detey-s-mukovistsidozom/viewer (in Russian).
16. Chepurnaya M.M., Yagubyants E.T., Kharakhash’yan L.E. et al. [Inhaled tobramycin for hospital treatment of children with cystic fibrosis]. Prakticheskaya pul’monologiya. 2017; (1): 42-44. Available at: https://cyberleninka.ru/article/n/opyt-primeneniya-ingalyatsionnogo-tobramitsina-u-detey-s-mukovistsidozom-v-usloviyah-statsionara/viewer (in Russian).
17. Golubtsova O.I., Gorinova Yu.V., Krasnov M.V. et al. [Inhaled tobramycin for the treatment of chronic pseudomonas aeruginosa infection in children with cystic fibrosis in the Chuvash Republic]. Prakticheskaya pul’monologiya. 2017; (3): 40-45. Available at: https://cyberleninka.ru/article/n/opyt-primeneniya-ingalyatsionnogo-tobramitsina-pri-hronicheskoy-sinegnoynoy-infektsii-u-detey-s-mukovistsidozom-v-chuvashskoy/viewer (in Russian).
18. Pavlinova E.B., Mingairova A.G., Safonova T.I. et al. [Clinical significance of lung microbiota and experience of the inhaled antibacterial therapy in children of the Omsk Cystic Fibrosis Center (sase series)]. Pediatricheskaya farmakologiya. 2018; 15 (2): 121-128. https://doi.org/10.15690/pf.v15i2.1868 (in Russian).
19. [Cystic fibrosis: clinical guidelines. 2020]. Available at: http://cr.rosminzdrav.ru/recomend/372_1 (in Russian).
20. Quanjer P.H., Tammeling G.J., Cotes J.E. et al. Lung volumes and forced ventilatory flows. Eur. Respir. J. 1993; 6 (16): 5-40. https://doi.org/10.1183/09041950.005s1693.
21. Huskisson E.C. Measurement of pain. Lancet. 1974; 304 (7889): 1127-1131. https://doi.org/10.1016/s0140-6736(74)90884-8.
22. Solyanik E.V. [Use of psychometric visual analog scales in assessing of the severity of stable angina pectoris and the effectiveness of antianginal therapy]. Ratsional’naya farmakoterapiya v kardiologii. 2011; 7 (5): 591-595. Available at: https://cyberleninka.ru/article/n/ispolzovanie-psihometricheskih-vizualno-analogovyh-shkal-v-otsenke-stepeni-tyazhesti-stabilnoy-stenokardii-i-effektivnosti/viewer (in Russian).
23. Polikarpova S.V., Kondratyeva E.I., Shabalova L.A. et al. [Microflora of the respiratory tract in patients with cystic fibrosis and sensitivity to antibiotics based on a 15-year follow-up (2000-2015 years)]. Meditsinskiy sovet. 2016; (15): 84-89. https://doi.org/10.21518/2079-701X-2016-15-84-89 (in Russian).
24. Shaginyan I.A., Avetisyan L.R., Chernukha M.Yu. et al. [Epidemiological significance of genome variations in Pseudomonas aeruginosa causing chronic lung infection in patients with cystic fibrosis]. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2019; 21 (4): 340-351. https://doi.org/10.36488/cmac.2019.4.340-351 (in Russian).
25.
26.
Review
For citations:
Kondratyeva E.I., Voronkova A.Yu., Trishina S.V., Snetkova N.S., Safonova T.I., Pavlinova E.B., Chepurnaya M.M., Kharakhashyan L.E., Golubtsova O.I., Skachkova M.A., Kondakova Yu.A., Enina E.A., Vodovozova E.V. Study of efficacy, safety, and patient satisfaction with inhaled tobramycin (Tobramycin-Gobbi) in children with cystic fibrosis and pseudomonas infection. PULMONOLOGIYA. 2021;31(2):197-206. (In Russ.) https://doi.org/10.18093/0869-0189-2021-31-2-197-206
ISSN 2541-9617 (Online)