In vitro evaluation of aerosol delivery of aztreonam lysine (AZLI): an adult mechanical ventilation model. (2nd December 2017)

• Record Type: Journal Article
• Authors: Rodríguez, Alejandro; Cabrera, María; Reyes, Luis F.; Bodí, María; Trefler, Sandra; Canadell, Laura; Barahona, Diego; Ehrmann, Stepham; Martin-Loeches, Ignacio; Restrepo, Marcos I.; Vecellio, Laurent
• Is Part Of: Expert opinion on drug delivery. Volume 14:Number 12(2017:Dec.)
• Page Start: 1447
• Page End: 1453
• Publication Date: 2017-12-02
• Subjects: Aztreonam lysine -- aerosol delivery -- nebulized antibiotic -- mechanical ventilation -- in vitro model; Drug delivery devices -- Periodicals; Drug delivery systems -- Periodicals; 615.605
• DOI: 10.1080/17425247.2017.1393411
• Languages: English
• ISSNs: 1742-5247

Abstract

ABSTRACT: Background : The delivery profile of Aztreonam lysine (AZLI) during mechanical ventilation (MV) is unknown. We evaluated the amount of AZLI drug delivered using an in vitro model of adult MV. Methods : An adult lung model designed to mimic current clinical practice was used. Both nebulizers were placed before a Y-piece and 4 settings were tested: A) Aeroneb solo® [AS] with a t-piece; B) AS with the spacer; C) M-Neb® [MN] with a t-piece and D) MN with the spacer. Performance was evaluated in terms of: 1) Mass median aerodynamic diameter (MMAD); 2) Geometric standard deviation (GSD), 3) Fine particle dose (FPD), 4) Fine particle fraction (FPF), 5) Inhalable mass (IM), and 6) Recovery rate (RR). Results : Both devices showed an adequate delivery of AZLI during MV, with MMAD between 2.4–2.5 µm and 87% of FPF. The FPD (38.8 and 31.7), IM (44.8 and 36.1) and RR (30 and 24) were similar for AS and MN respectively. Nebulizer aerosol delivery increased (50 and 70% respectively) for both nebulizers when using the spacer. Conclusion : Both AS and MN showed a good aerosol delivery profile for AZLI during in vitro mechanical ventilation. Better aerosol delivery performance was obtained using the spacer.