Abstract
Persistent colonization of the respiratory tract with μs. aerug. is a major problem in children with cystic fibrosis (CF). Because gentamicin penetration of CF sputum is inadequate after parenteral administration, we undertook an investigation of the safety and efficacy of gentamicin aerosol. Nine CF children (5F, 4M) ages 6-15 years with moderately severe disease were studied. Following baseline pulmonary and microbial studies, each child received 40 mg of gentamicin sulfate by nebulization three times daily for one week. Gentamicin disposition and pulmonary function were studied initially and at the end of the treatment program. No adverse effects from the treatment were observed. Peak sputum concentrations of gentamicin varied from 3.6 to 18.5 mcg/ml after one dose to 6.4 to 33 mcg/ml after one week of therapy. Peak blood concentrations ranged from 0 to 0.35 mcg/ml initially and were somewhat higher at the end of the treatment program. Urinary concentrations were insignificant. The mean clearance of gentamicin from the sputum was 51 ml/min/1.73 m2 (6 pts). Microbial studies in five patients demonstrated a striking decrease in pseudomonas colony counts. No strains developed resistance to gentamicin. Pulmonary function tests improved in 5 patients, showed no change in 3, and diminished in 1, perhaps in association with a clinical URI. All the children showed marked clinical improvement. These results provide a rationale for, and strongly warrant, a clinical trial of aerosolized gentamicin in CF patients.
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Danish, M., Arbeter, A., Rosenlund, M. et al. AEROSOLIZED GENTAMICIN IN CYSTIC FIBROSIS. Pediatr Res 11, 415 (1977). https://doi.org/10.1203/00006450-197704000-00277
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DOI: https://doi.org/10.1203/00006450-197704000-00277
