fosfomycin and Bronchitis

This clinical trial evaluated the pharmacokinetics and safety/tolerability of amikacin/fosfomycin solution using a vibrating plate nebulizer, in mechanically ventilated patients with ventilator-associated tracheobronchitis (VAT) or ventilator-associated pneumonia (VAP).. Nine adult patients were consented to receive three escalating doses of a combination of 50 mg/mL amikacin and 20 mg/mL fosfomycin; doses were separated by 24±2 hr. On day 3, patients received two blinded, randomized treatments (amikacin/fosfomycin and volume-matched placebo), separated by 2 hr. All treatments were administered with a single-patient, multitreatment nebulizer (Investigational eFlow(®) Inline Nebulizer System; PARI Pharma GmbH, positioned in the inspiratory limb tubing between the ventilator and the patient. The nebulizer remained in-line until all treatments had been delivered. Concentrations of amikacin and fosfomycin were measured in tracheal aspirate and plasma samples obtained during the 24 hr after each dose.. Fifteen minutes after dosing with the 300/120 mg amikacin/fosfomycin combination, tracheal aspirate amikacin concentrations±SD were 12,390±3,986 μg/g, and fosfomycin concentrations were 6,174±2,548 μg/g (n=6). Airway clearance was rapid. Plasma concentrations were subtherapeutic; the highest observed amikacin plasma concentration was 1.4 μg/mL, and the highest observed fosfomycin plasma concentration was 0.8 μg/mL. Administration time was approximately 2 min/mL. No adverse effects on respiratory rate, peak airway pressures, or oxygenation were observed during or following drug or placebo administration.. High tracheal aspirate concentrations of amikacin and fosfomycin were achieved in mechanically ventilated patients with VAT or VAP after aerosolized administration with an inline nebulizer system. Airway clearance was rapid. No adverse respiratory effects were noted during or following drug administration.

Topics: Administration, Inhalation; Adult; Aerosols; Aged; Aged, 80 and over; Amikacin; Anti-Bacterial Agents; Bronchitis; Double-Blind Method; Drug Combinations; Drug Monitoring; Equipment Design; Fosfomycin; Humans; Male; Middle Aged; Nebulizers and Vaporizers; Pneumonia, Ventilator-Associated; Respiration, Artificial; Tracheitis; Victoria

Topics: Acidosis, Respiratory; Adult; Aged; Anti-Bacterial Agents; Bronchitis; Bronchopneumonia; Female; Fosfomycin; Humans; Lung Diseases, Obstructive; Male; Middle Aged

Topics: Adolescent; Anti-Bacterial Agents; Bronchitis; Child; Child, Preschool; Fosfomycin; Humans; Laryngitis; Respiratory Tract Infections; Tracheitis

Fosfomycin has been tested in 25 adult patients with bronchial or bronchopulmonary acute processes, of which 13 were simple acute processes of a greater or lesser severity, and 12 acutenesses of chronic bronchial processes. The germs found most frequently in the sputum cultures were Streptococcus pneumoniae and Klebsiella. Fosfomycin was used intramuscularly with doses of 4 g/day, for an average of 10 days. The results obtained were 16 cures, 7 improvements and 2 failures, which represents 92% success with 8% failures.

Topics: Acute Disease; Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Chronic Disease; Drug Evaluation; Female; Fosfomycin; Humans; Injections, Intramuscular; Male; Middle Aged; Sputum

Reference is made to the results obtained in 24 children, from 11 months to 12 years, affected with acute pneumopathies and treated with fosfomycin with a dosage of 200 mg/kg/day. In all cases a clinical, radiological, biological and bacteriological study was carried out. At the same time, levels of fosfomycin in plasma and sputum were checked every 5 days during the course of treatment. In the 4 cases of pleurisy the level of antibiotic in the pleural liquid was also checked. The concentration of fosfomycin in the sputum gives very variable results with average values oscillating between 16.5 and 23.4% of the plasmatic level respectively at the beginning and end of treatment, a cumulative effect of the antibiotic being observed. Concentration in pleural liquid oscillates between 39 and 50%. The clinical, radiological and biological evolution has been favourable iin 21 cases, unfavourable in two cases and in one case treatment had to be suspended because of the apparition of a cutaneous necrosis. Apart from this case no notable toxic effects were observed. Children do not support intramuscular injections very well and intravenous injections often cause phlebitis.

Topics: Anti-Bacterial Agents; Bronchitis; Child; Child, Preschool; Drug Evaluation; Fosfomycin; Humans; Infant; Pleura; Pleurisy; Pneumonia; Respiratory Tract Infections; Sputum; Tracheitis