Improvement of nebulised antibiotic delivery in cystic fibrosis. Issue 4 (1st April 1999)

• Record Type: Journal Article
• Authors: Wilson, Daniel; Burniston, Maria; Moya, Eduardo; Parkin, Adrian; Smye, Stephen; Robinson, Phillip; Littlewood, James
• Is Part Of: Archives of disease in childhood. Volume 80:Issue 4(1999)
• Page Start: 348
• Page End: 352
• Publication Date: 1999-04-01
• Subjects: cystic fibrosis -- nebulised antibiotics -- nuclear medicine -- particle size; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/adc.80.4.348
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : AIM: To investigate deposition patterns and to assess the delivery rate of two nebuliser systems in children with cystic fibrosis (CF). METHODS: Thirty three children with CF on regular treatment with nebulised antibiotics had radioisotope scans performed using technetium-99m labelled aerosol antibiotic generated by a Ventstream nebuliser (median mass diameter (MMD), 3.3 μm; delivery rate, 0.075 ml/min) under conditions similar to their routine home practice. The inhomogeneity of the images was scored on a 1–10 rating scale (a low score indicating even distribution of the antibiotic), and stomach deposition was measured as a percentage of overall deposition. Twenty patients had a repeat scan using an Optimist nebuliser (MMD, 1.8 μm; delivery rate, 0.02 ml/min). RESULTS: The mean inhomogeneity scores were 5.4 in the Ventstream group and 3.5 in the Optimist group. Mean stomach deposition was 17.3% in the 33 patients using the Ventstream nebuliser. There was an inverse relation between height and stomach deposition ( r = 0.69). In the 20 patients who had both nebulisers, the mean percentages of stomach deposition for the Ventstream and Optimist nebulisers were 11.8% and 1.6%, respectively. The Ventstream nebuliser delivered antibiotic at an average 2.8 times faster rate than the Optimist nebuliser. IMPLICATIONS: A smaller particle size results in a more homogenous distribution of the antibiotic in the lungs with decreased stomach deposition. This should not be seen as a recommendation to use the Optimist nebuliser because more antibiotic was delivered to most parts of the lung with the Ventstream because of its increased delivery rate.