Preview

Current Pediatrics

Advanced search

THE PERFORMANCE OF A LONG-TERM ANTIBACTERIAL THERAPY IN CHILDREN WITH CYSTIC FIBROSIS DURING PRIMARY PLATING OF PSEUDOMONAS AERUGINOSA

https://doi.org/10.15690/vsp.v13i6.1205

Abstract

Background: A long-term plating of Pseudomonas aeruginosa in patients with cystic fibrosis is a sign of damage of the lung tissues with rapid progression of the disease and decrease in a respiratory function. The early pathogen detection is necessary for the timely prescription of an antibiotic for the purpose of a complete eradication of P. aeruginosa. Objective: Our aim was to determine the efficiency and safety of an inhalation form of the colistimethate sodium antibiotic in children with cystic fibrosis during the initial detection of P. aeruginosa. Methods: In a retrospective continuous study it was analyzed the results of inhalation use of the colistimethate sodium in a dose of 2 million IU/day in children with moderate cystic fibrosis with newly diagnosed P. aeruginosa. Results: The analysis included data of 25 children at the age of 2–10 years, 17 of them were treated with colistimethate sodium for 6 months, 8 — for 12 months. P. aeruginosa eradication was detected in 22 (88%) children. Children, who received antibiotic therapy for 6 months, at the end of the treatment showed an increase in forced expiratory volume for the 1st second (FEV-1) from 67.1 ± 2.2 to 80.4 ± 1.9% (р = 0.012), but in 3 months without inhalations there was a decrease in indicator values (to 75.9 ± 5.7%; p = 0.069). With the duration of inhalations of 12 months, the value FEV-1 indicator also increased: from 65.9 ± 3.8 to 81.5 ± 3.1% (р = 0.011). However, in the following 3 months without therapy these children did not have any significant decrease in FEV-1 (80.6 ± 3.4%; р = 0.073). There were no allergic reactions during the treatment; bronchospasm was observed in one child. For the entire period of management any P. aeruginosa strain, resistant to the colistimethate sodium, was not revealed. Conclusion: During the initial detection of P. aeruginosa in children with cystic fibrosis, a long-term therapy, including inhalations with colistimethate sodium, leads to a bacterial eradication and restoration of a respiratory function.
Key words: children; cystic fibrosis; chronic Pseudomonas aeruginosa infection; treatment; colistimethate sodium; inhalations.

About the Authors

О. I. Simonova
Scientific Centre of Children Health, Moscow; Sechenov First Moscow State Medical University
Russian Federation


Yu. V. Gorinova
Scientific Centre of Children Health, Moscow
Russian Federation


А. V. Lazareva
Scientific Centre of Children Health, Moscow
Russian Federation


N. I. Burkina
Scientific Centre of Children Health, Moscow
Russian Federation


References

1. Симонова О. И., Лазарева А. В., Мотузова О. В., Пономаренко О. А., Катосова Л. К., Чистякова В. П., Буркина Н. И. Новые возможности антибиотикотерапии при острой и хронической респираторной патологии у детей. Вопросы современной педиатрии. 2013; 12 (1): 123–130.

2. Соловьёва Ю. В. Клиническое значение протеолиза-антипротеолиза у детей с врожденными пороками развития бронхолегочной системы и муковисцидозом. Автореф. дис. … канд. мед. наук. М. 2013. 25 с.

3. Hoiby N. Microbiology of lung infections in cystic fibrosis patients. Acta Paediatr. Scand. Suppl. 1982; 301: 33–54.

4. Emerson J., Rosenfeld M., McNamara S., Ramsey B., Gibson R. L. Pseudomonas aeruginosa and other predictors of mortality and morbidity in young children with cystic fibrosis. Pediatr. Pulmonol. 2002; 34: 91–100.

5. Geller D. E., Pitlick W. H., Nardella P. A., Tracewell W. G., Ramsey B. W. Pharmacokinetics and bioavailability of aerosolized tobramycin in cystic fibrosis. Chest. 2002; 122: 219–226.

6. URL: http://www.clsi.org (дата обращения: 04.12.2014).

7. European Committee on Antimicrobial Susceptibility Testing (EUCAST). URL: http://www.eucast.org. (дата обращения: 04.12.2014).

8. URL: http://www.docs.cntd.ru. (дата обращения: 04.12.2014).

9. Муковисцидоз. Под ред. Н. И. Капранова, Н. Ю. Каширской. М.: Медпрактика-М. 2014. С. 37–191.

10. Kerem E., Conway S., Elborn S., Heijerman H. Standards of care for patients with cystic fibrosis: A European consensus. J. Cyst. Fibrosis. 2005; 4: 7–26.

11. Armstrong D. S., Grimwood K., Carlin J. B., Carzino R., Gutierrez J. P., Hull J. Lower airway inflammation in infants and young children with cystic fibrosis. Am. J. Respir. Crit. Care Med. 1997; 156: 1197–1204.

12. Rosenfeld M., Ramsey B. W., Gibson R. L. Pseudomonas acquisition in young patients with cystic fibrosis: pathophysiology, diagnosis, and management. Curr. Opin. Pulm. Med. 2003; 9 (6): 492–497.

13. Smyth A. R., Bell S. C., Bojcin S., Bryon M., Duff A., Flume P., Kashirskaya N., Munck A., Ratjen F., Schwarzenberg S. J., Sermet- Gaudelus I., Southern K. W., Taccetti G., Ullrich G., Wolfe S. European Cystic Fibrosis Society Standards of Care: Best Practice guidelines. J. Cyst. Fibrosis. 2014; 13: 23–42.

14. Doring G., Conway S.P., Heijerman H. G., Hodson M. E., Hoiby N., Smyth A., Touw D. J. Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus. Eur. Respir. J. 2000; 16 (4): 749–767.

15. Национальный консенсус по муковисцидозу. Раздел «Анти- микробная терапия». Педиатрия. 2014; 93 (4): 107–123.

16. Дмитриева Н. В., Григорьевская З. В., Дьякова С. А., Ключникова И. А., Петухова И. Н. Разработка стратегических подходов терапии инфекций, вызванных мультирезистентными Acinetobacter baumannii. Сибирский онкологический журнал. 2012; 4 (52): 11–19.

17. Gales A. C., Reis A. O., Jones R. N. Contemporary assessment of antimicrobial susceptibility testing metods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines. J. Clin. Microbiol. 2001; 39: 183–190.

18. Beringer P. The clinical use of colistin in patients with cystic fibrosis. Curr. Opin. Pulm. Med. 2001; 7: 434–440.

19. Гельфанд Б. Р., Проценко Д. Н., Белоцерковский Б. З., Мамонтова О. А. Эффективность колистиметата натрия в лечении «поздней» нозокомиальной пневмонии, связанной с проведением ИВЛ. Инфекции в хирургии. 2009; 7 (4): 16–19.

20. Лазарева А. В., Симонова О. И., Катосова Л. К. Колистиметат натрия в терапии у детей с муковисцидозом (опыт применения). Российский педиатрический журнал. 2009; 5: 29–31.

21. Christenson J. C. In vitro activity of meropenem, imipenem, cefepim and цефтазидим against Pseudomonas aeruginosa isolates from cystic fibrosis patients. J. Antimicrob. Chemother. 2000; 45: 899–901.

22. Falagasa M. E., Vouloumanoua E. K., Rafailidis P. I. Systemic colistin use in children without cystic fibrosis: a systematic review of the literature. Int. J. Antimicrob. Agents. 2009; 33 (503): 1–13.

23. Tamma P., Newland J., Pannaraj P., Metjian T., Banerjee R., Gerber J. The use of intravenous Colistin among сhildren in the United States: results from a multicenter, case series. Pediatr. Infect. Dis. J. 2009; 28: 534–535.

24. Li J., Turnidge J., Milne R., Nation R. L., Coulthard K. In vitro pharmacodynamic properties of colistin and colistin metha nesulfonate against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrob. Agents Chemother. 2001; 45: 781–785.

25. Ratjen F., Rietschel E., Kasel D., Schwiertz R., Starke K., Beier H. Pharmacokinetics of inhaled colistin in patients with cystic fibrosis. J. Antimicrob. Chemother. 2006; 57 (2): 306–311.

26. Johansen N. K. Рrolonged inhalation introduction of colistin is safe for patients with cystic fibrosis. J. Cyst. Fibrosis. 2003; 2 (39): 143.

27. Hansen C. R., Pressler T., Hoiby N. Early aggressive eradication therapy for intermittent Pseudomonas aeruginosa airway colonisation in cystic fibrosis patients: 15 years experience. J. Cyst. Fibrosis. 2006; 5 (Suppl. 1): 22.


Review

For citations:


Simonova О.I., Gorinova Yu.V., Lazareva А.V., Burkina N.I. THE PERFORMANCE OF A LONG-TERM ANTIBACTERIAL THERAPY IN CHILDREN WITH CYSTIC FIBROSIS DURING PRIMARY PLATING OF PSEUDOMONAS AERUGINOSA. Current Pediatrics. 2014;13(6):67-71. (In Russ.) https://doi.org/10.15690/vsp.v13i6.1205

Views: 970


ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)