Quantitative deposition of aerosolized gentamicin in cystic fibrosis
In cystic fibrosis (CF), the clinical effectiveness of aerosolized antibiotics is controversial. Previous investigators have not considered the type of nebulizer, droplet size, and dose to the lung in assessing the results of aerosol therapy. The present study tests the importance of these factors by standardizing an aerosol system for delivery of antibiotics and other agents to patients with CF. Particle size, distribution, and output from a commercially available nebulizer were measured. Thirteen patients with CF inhaled aerosol (MMAD = 1.1 micron) containing gentamicin (160 mg in nebulizer) and /sup 99m/Tc-labeled human serum albumin. Patients' sputum and serum were analyzed for gentamicin levels by immunoenzymatic assay. Using a gamma camera and suitable filters, central versus peripheral deposition (C/P ratio) and whole lung deposition were measured and related to sputum gentamicin levels. Gentamicin deposit averaged 12.3 mg +/- 5.9 (SD) or 7.69% of the original amount placed in the nebulizer. Peak sputum levels averaged 376.6 micrograms/ml +/- 275, whereas serum levels were undetectable in all patients. When peak sputum levels were normalized for the amount deposited, a close correlation with C/P ratio was obtained (r = 0.88, p less than 0.05). Furthermore, an inverse relationship was found between the C/P ratio and the %FEV1 (r = 0.76, p less than 0.05). Finally, a bell-shaped relationship between deposited dose and minute ventilation was seen in the patients (r = 0.88, p less than 0.05), i.e., an optimal minute ventilation was shown. These relationships may be important when designing future clinical studies.
- Research Organization:
- State Univ. of New York, Stony Brook
- OSTI ID:
- 5603947
- Journal Information:
- Am. Rev. Respir. Dis.; (United States), Vol. 136:6
- Country of Publication:
- United States
- Language:
- English
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ANTIBIOTICS
INHALATION
RESPIRATORY SYSTEM DISEASES
THERAPY
AEROSOLS
ALBUMINS
CALIBRATION
ENZYME IMMUNOASSAY
ISOMERIC NUCLEI
PARTICLE SIZE
PATIENTS
TECHNETIUM 99
TRACER TECHNIQUES
ANTI-INFECTIVE AGENTS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
COLLOIDS
DISEASES
DISPERSIONS
DRUGS
HOURS LIVING RADIOISOTOPES
IMMUNOASSAY
INTAKE
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PROTEINS
RADIOISOTOPES
SIZE
SOLS
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES
550901* - Pathology- Tracer Techniques