Eradication of Pseudomonas aeruginosa in cystic fibrosis patients with inhalation of dry powder tobramycin

BACKGROUND: Pseudomonas aeruginosa (Pa) is the predominant pulmonary pathogen in patients with cystic fibrosis (CF). Tobramycin nebulization is used for the eradication of Pa infection. Nowadays, tobramycin dry powder inhalation (DPI) is available as well. This study reports the results of eradicating Pa with tobramycin DPI versus nebulization. METHODS: Adult CF patients with a Pa isolation between September 2010 and September 2017 from the University Medical Centre Groningen (UMCG), the Netherlands, were included in this retrospective study. RESULTS: In total 27 Pa isolations were recorded. In 13 of these, eradication was attempted with tobramycin, 7 with DPI and 6 with nebulization. DPI eradicated Pa successfully in six isolations (85.7%). Of these, one patient received additional oral ciprofloxacin and one received intravenous ceftazidime. Nebulization eradicated three Pa isolations (50.0%), in two of these, additional oral ciprofloxacin was given. CONCLUSION: Eradication rates of DPI tobramycin are comparable with those for nebulized tobramycin reported in the literature. This study suggests that DPI tobramycin is an alternative to nebulized tobramycin for eradication of Pa. TRIAL REGISTRATION: The Medical Ethics Committee of the UMCG granted a waiver (METC2017-349), as they concluded that this study was not subject to the Medical Research Involving Human Subjects Act. The reviews of this paper are available via the supplemental material section

Adverse Drug Reactions in Mazandaran Province, Iran, 2004-2018

Background and purpose: Adverse drug reaction (ADR) is one of the major causes of mortality and morbidity in patients that results in high healthcare costs. This study was conducted in Food and Drug Deputy at Mazandaran University to evaluate ADRs in Mazandaran province. Materials and methods: The analysis was performed during 2004-2018, based on the frequency of the drugs that had side effects, routes of administration, the number of reports per year, patient characteristics (gender, age), the frequency of the organ damaged, and the reporter. Results: A total of 4425 reports of ADRs were submitted to Adverse Drug Reactions Center in Food and Drug Department, Mazandaran province, Iran. More than half of the reports (61%) were reported by nurses and 58.4% of the ADRs occurred in women. Injectable drugs were found with more adverse effects (75.7%) and the most prevalent were skin and hair disorders (50.6%). Anti-infective agents were the top drugs that caused ADRs (52.2%) and ceftriaxone was the most prevalent. Conclusion: Due to the low number of ADRs in Mazandaran province and its low concordance with international standards, it seems that trainings based on the needs and preferences of medical groups about pharmacovigilance and focuses on how to report, can increase their awareness and knowledge about ADR and bring the data closer to world standards