Article
Pediatrics
Tiffany E. Burrus, Hilary Vogt, Rebecca S. Pettit
Summary: The addition of a pharmacy technician/pharmacist team in conjunction with an integrated health-system specialty pharmacy (IHSSP) reduced the time from culture to TIS being received by CF patients. Patients who filled prescriptions at the IHSSP received their medication sooner compared to an external specialty pharmacy, highlighting the benefits of the integrated pharmacy model.
PEDIATRIC PULMONOLOGY
(2021)
Review
Cardiac & Cardiovascular Systems
Saveria Sangiovanni, Eliana Morales, Liliana Fernandez-Trujillo
Summary: Inhaled tobramycin can temporarily decrease P. aeruginosa density in sputum and reduce hospital admissions in NCFBE patients, but has limited impact on eradicating the bacteria and frequency of exacerbations.
RESPIRATORY MEDICINE
(2021)
Article
Multidisciplinary Sciences
Silvia M. Caceres, Linda A. Sanders, Noel M. Rysavy, Katie R. Poch, Caroline R. Jones, Kyle Pickard, Tasha E. Fingerlin, Roland A. Marcus, Kenneth C. Malcolm, Jennifer L. Taylor-Cousar, David P. Nichols, Jerry A. Nick, Matthew Strand, Milene T. Saavedra
Summary: This study found that specific genes measured from peripheral blood leukocytes can predict clinical response to inhaled antibiotic therapy in patients with cystic fibrosis. Molecular quantification of systemic inflammation may indicate subgroups of CF patients with variations in underlying inflammation and with variable clinical responses to inhaled antibiotics.
Article
Immunology
Jonathan D. Cogen, Anna Faino, Frankline Onchiri, Lucas R. Hoffman, Matthew P. Kronman, David P. Nichols, Margaret Rosenfeld, Ronald L. Gibson
Summary: A retrospective cohort study found that there were no significant differences in respiratory and clinical outcomes between young patients with cystic fibrosis treated with one versus two intravenous antipseudomonal antibiotics for pulmonary exacerbations.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Infectious Diseases
Giovanni Taccetti, Michela Francalanci, Giovanna Pizzamiglio, Barbara Messore, Vincenzo Carnovale, Giuseppe Cimino, Marco Cipolli
Summary: Inhaled antibiotics have greatly improved respiratory diseases in cystic fibrosis patients, especially in treating chronic Pseudomonas aeruginosa infections. These antibiotics offer advantages over systemic therapy by delivering high drug concentrations directly to the lungs. Alternating treatment with inhaled antibiotics is crucial for improving patient outcomes, and long-term use can prevent acute pulmonary exacerbations.
Article
Immunology
Jonathan D. Cogen, Frankline M. Onchiri, Nicole Mayer Hamblett, Ronald L. Gibson, Wayne J. Morgan, Margaret Rosenfeld
Summary: The study showed that prolonged use of oral antibiotics in children with cystic fibrosis increased the risk of acquiring Achromobacter xylosoxidans, while treatment with intravenous antibiotics was associated with an increased risk of acquiring multidrug-resistant Pseudomonas aeruginosa and MRSA.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Cardiac & Cardiovascular Systems
J. Stuart Elborn, Francesco Blasi, Charles S. Haworth, Manfred Ballmann, Harm A. W. M. Tiddens, Marlene Murris-Espin, James D. Chalmers, Andre M. Cantin
Summary: Inhaled tobramycin therapy has shown effectiveness in reducing P. aeruginosa microbial density in sputum of bronchiectasis patients, leading to potential clinical benefits such as reduced hospitalizations, exacerbations, and symptoms. Definitive phase 3 trials are needed to determine the clinical efficacy and long-term safety of inhaled tobramycin in bronchiectasis patients with chronic P. aeruginosa infection.
RESPIRATORY MEDICINE
(2022)
Article
Infectious Diseases
Giovanna Batoni, Elisa Catelli, Esinguel Kaya, Arianna Pompilio, Marta Bianchi, Emilia Ghelardi, Giovanni Di Bonaventura, Semih Esin, Giuseppantonio Maisetta
Summary: Therapy of lung infections caused by Pseudomonas aeruginosa in cystic fibrosis patients is challenging due to the presence of sticky mucus and antibiotic-tolerant biofilm. This study evaluates the growth of probiotic strains in an artificial sputum medium and their effects on planktonic and biofilm growth of clinical strains of P. aeruginosa. The results show that Lacticaseibacillus rhamnosus and Lactiplantibacillus plantarum can grow in the sputum medium and inhibit the growth of P. aeruginosa, including the pre-formed biofilm.
Article
Respiratory System
Ramaa Puvvadi, Helga Mikkelsen, Lucy McCahon, Samantha Grogan, William Ditcham, David W. Reid, Iain Lamont, Stephen M. Stick, Barry Clements
Summary: This study found that adding Tris-CaEDTA to nebulised tobramycin could increase P. aeruginosa clearance and improve lung function in CF patients, although the differences were not statistically significant. The treatment was also shown to be safe and well-tolerated.
JOURNAL OF CYSTIC FIBROSIS
(2021)
Article
Pharmacology & Pharmacy
Carsten Schwarz, Claudio Procaccianti, Benjamin Mignot, Hosein Sadafi, Nicolas Schwenck, Xabier Murgia, Federico Bianco
Summary: This study used Functional Respiratory Imaging (FRI) to predict the lung deposition of Levofloxacin in CF patients, finding that shorter inspiratory times and higher inspiratory flow rates significantly reduced deposition in the lung periphery. A modest correlation was observed between the central-to-peripheral deposition (C/P) ratio of levofloxacin and FEV1, with FRI analysis revealing structural differences in airways of mild and moderate CF patients.
Article
Microbiology
Michael Marner, Laura Kolberg, Julia Horst, Nils Boehringer, Johannes Huebner, I. Dewa M. Kresna, Yang Liu, Ute Mettal, Lei Wang, Melanie Meyer-Buehn, Sanja Mihajlovic, Matthias Kappler, Till F. Schaeberle, Ulrich von Both
Summary: Antimicrobial resistance poses an increasing threat to healthcare. To address the need for innovative treatment of respiratory infections, antibiotics with new modes of action need to be developed. This study generated the antibiogram of clinical isolates from cystic fibrosis patients and identified bicyclic heptapeptides that inhibit the outer membrane protein BamA, showing strong activity against multidrug-resistant strains.
MICROBIOLOGY SPECTRUM
(2023)
Review
Infectious Diseases
Danni Li, Elena K. Schneider-Futschik
Summary: Impaired mucus transport and enhanced colonization of bacteria in cystic fibrosis patients lead to pulmonary infection, causing significant morbidity and mortality. Pseudomonas aeruginosa and Staphylococcus aureus are the most common bacteria found in CF lungs, and they undergo adaptational mechanisms such as biofilm formation, resulting in chronic infections. Inhaled antibiotics, such as tobramycin, aztreonam, levofloxacin, and colistin, are used to treat chronic pulmonary infections with advantages of higher airway concentration and lower systemic toxicity.
Article
Pharmacology & Pharmacy
Nasser Alhajj, Niall J. O'Reilly, Helen Cathcart
Summary: This review discusses the challenges in developing ciprofloxacin powder for inhalation for CF patients, as well as the rationale behind recent formulations of ciprofloxacin dry powder for inhalation. The challenges include ciprofloxacin lung permeability, overproduction of viscous mucus, and bacterial biofilms. The review also explores current and emerging particle engineering approaches to overcome these challenges.
INTERNATIONAL JOURNAL OF PHARMACEUTICS
(2022)
Article
Respiratory System
Jonathan D. Cogen, Anna Faino, Frankline Onchiri, Ronald L. Gibson, Lucas R. Hoffman, David P. Nichols, Margaret Rosenfeld, Matthew P. Kronman
Summary: The selection of antibiotics for managing pulmonary exacerbation in children with cystic fibrosis is usually based on previous respiratory culture results. However, there is currently a lack of data to guide the selection of antibiotics for children who have been culture negative for Pseudomonas aeruginosa (Pa) for at least one year.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2022)
Review
Respiratory System
J. Stuart Elborn, Francesco Blasi, Pierre-Regis Burgel, Daniel Peckham
Summary: Recurrent and chronic bacterial infections are common in people with cystic fibrosis (CF). Antibiotics are the mainstay in treatment, but inhaled antibiotics have limited systemic adverse effects. In the past decade, highly effective CFTR modulators have become a new therapy that partially corrects chloride transport, improving lung function. While these modulators have a significant impact, they do not fully resolve chronic lung damage. This article reviews the role of inhaled antibiotics in the era of CFTR modulators.
EUROPEAN RESPIRATORY REVIEW
(2023)
Article
Critical Care Medicine
Dave P. Nichols, Katherine Odem-Davis, Jonathan D. Cogen, Christopher H. Goss, Clement L. Ren, Michelle Skalland, Ranjani Somayaji, Sonya L. Heltshe
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2020)
Article
Immunology
Kerstin Pohl, Xue A. Grimm, Silvia M. Caceres, Katie R. Poch, Noel Rysavy, Milene Saavedra, Jerry A. Nick, Kenneth C. Malcolm
INFECTION AND IMMUNITY
(2020)
Article
Respiratory System
Kelsie Pearson, Nicole Mayer-Hamblett, Christopher H. Goss, George Z. Retsch-Bogart, Jill M. VanDalfsen, Patricia Burks, Daniel Rosenbluth, John Paul Clancy, Amy Hoffman, David P. Nichols
Summary: The global pandemic of SARS-CoV-2 significantly impacted CF clinical research, but over time, research activities gradually recovered and new opportunities for CF research emerged.
JOURNAL OF CYSTIC FIBROSIS
(2021)
Review
Respiratory System
Dave P. Nichols, Scott H. Donaldson, Carla A. Frederick, Steven D. Freedman, Daniel Gelfond, Lucas R. Hoffman, Andrea Kelly, Michael R. Narkewicz, Jessica E. Pittman, Felix Ratjen, Scott D. Sagel, Margaret Rosenfeld, Sarah Jane Schwarzenberg, Pradeep K. Singh, George M. Solomon, Michael S. Stalvey, Shannon Kirby, Jill M. VanDalfsen, John P. Clancy, Steven M. Rowe
Summary: Highly effective CFTR modulator drug therapy is increasingly available for cystic fibrosis patients, with multiple observational research studies underway to better understand its impacts. The PROMISE study focuses on the broad impacts of starting elexacaftor/tezacaftor/ivacaftor in the US population, aiming to address important health outcomes, clinical care priorities, and research needs.
JOURNAL OF CYSTIC FIBROSIS
(2021)
Article
Respiratory System
Eden J. VanDevanter, Sonya L. Heltshe, Michelle Skalland, Noah Lechtzin, Dave Nichols, Christopher H. Goss
Summary: The study findings suggest that in this cohort, PO antimicrobial treatment of CF PEx were less effective than IVs at improving ppFEV1 during treatment.
JOURNAL OF CYSTIC FIBROSIS
(2021)
Article
Respiratory System
Amalia S. Magaret, Jack Salerno, Jason F. Deen, Margaret Kloster, Nicole Mayer-Hamblett, Bonnie W. Ramsey, Dave P. Nichols
Summary: The study showed that chronic Azithromycin use in children with CF was not associated with an increased risk of QT prolongation.
JOURNAL OF CYSTIC FIBROSIS
(2021)
Article
Cell Biology
Juan Manuel Belardinelli, Deepshikha Verma, Wei Li, Charlotte Avanzi, Crystal J. Wiersma, John T. Williams, Benjamin K. Johnson, Matthew Zimmerman, Nicholas Whittel, Bhanupriya Angala, Han Wang, Victoria Jones, Veronique Dartois, Vinicius C. N. de Moura, Mercedes Gonzalez-Juarrero, Camron Pearce, Alan R. Schenkel, Kenneth C. Malcolm, Jerry A. Nick, Susan A. Charman, Timothy N. C. Wells, Brendan K. Podell, Jonathan L. Vennerstrom, Diane J. Ordway, Robert B. Abramovitch, Mary Jackson
Summary: This study found that antimalarial drugs can serve as potent inhibitors of M. abscessus, offering potential for clinical treatment.
SCIENCE TRANSLATIONAL MEDICINE
(2022)
Article
Biochemistry & Molecular Biology
Jerry A. Nick, Rebekah M. Dedrick, Alice L. Gray, Eszter K. Vladar, Bailey E. Smith, Krista G. Freeman, Kenneth C. Malcolm, L. Elaine Epperson, Nabeeh A. Hasan, Jo Hendrix, Kimberly Callahan, Kendra Walton, Brian Vestal, Emily Wheeler, Noel M. Rysavy, Katie Poch, Silvia Caceres, Valerie K. Lovell, Katherine B. Hisert, Vinicius Calado de Moura, Delphi Chatterjee, Prithwiraj De, Natalia Weakly, Stacey L. Martiniano, David A. Lynch, Charles L. Daley, Michael Strong, Fan Jia, Graham F. Hatfull, Rebecca M. Davidson
Summary: This study describes a successful phage treatment of treatment-refractory Mycobacterium abscessus pulmonary infection in a patient with severe lung disease. The phages used in the treatment were engineered to enhance their ability to lyse M. abscessus and were specifically selected based on their effectiveness against the patient's bacterial isolate. The treatment resulted in genetic stability of the bacterial isolate and improved clinical symptoms in the patient.
Article
Multidisciplinary Sciences
Silvia M. Caceres, Linda A. Sanders, Noel M. Rysavy, Katie R. Poch, Caroline R. Jones, Kyle Pickard, Tasha E. Fingerlin, Roland A. Marcus, Kenneth C. Malcolm, Jennifer L. Taylor-Cousar, David P. Nichols, Jerry A. Nick, Matthew Strand, Milene T. Saavedra
Summary: This study found that specific genes measured from peripheral blood leukocytes can predict clinical response to inhaled antibiotic therapy in patients with cystic fibrosis. Molecular quantification of systemic inflammation may indicate subgroups of CF patients with variations in underlying inflammation and with variable clinical responses to inhaled antibiotics.
Article
Microbiology
Kenneth C. Malcolm, Emily A. Wheeler, Kara Calhoun, Patricia M. Lenhart-Pendergrass, Noel Rysavy, Katie R. Poch, Silvia M. Caceres, Milene T. Saavedra, Jerry A. Nick
Summary: This study describes a method for detecting plasma anti-M. abscessus antibodies in individuals with CF. The assay is sensitive and provides information on the immune response to NTM infections. This test could be used to identify individuals with NTM pulmonary infections and track disease progression, either alone or in conjunction with other tests.
MICROBIOLOGY SPECTRUM
(2022)
Article
Immunology
Jerry A. Nick, Kenneth C. Malcolm, Emily A. Wheeler, Noel M. Rysavy, Katie Poch, Silvia Caceres, Valerie K. Lovell, Emily Armantrout, Katherine B. Hisert, Milene T. Saavedra, Kara Calhoun, Delphi Chatterjee, Ibrahim Aboellail, Stacey L. Martiniano, Fan Jia, Rebecca M. Davidson
Summary: Nontuberculous mycobacteria (NTM) is an opportunistic pathogen that affects a subset of cystic fibrosis (CF) patients, leading to increased morbidity and mortality. Current clinical detection methods rely on airway cultures, which are insensitive and unsuitable for population screening or disease monitoring. The lack of sensitive and quantitative markers hinders patient care and clinical trial design. Culture-independent markers, including bacterial products, DNA, and immune response markers, offer improved sensitivity but may not distinguish between different NTM species. These markers have the potential to enhance diagnosis and treatment monitoring when combined with traditional cultures.
Article
Microbiology
Patricia M. M. Lenhart-Pendergrass, Kenneth C. C. Malcolm, Emily Wheeler, Noel M. M. Rysavy, Katie Poch, Silvia Caceres, Kara M. M. Calhoun, Stacey L. L. Martiniano, Jerry A. A. Nick
Summary: This study investigated the immune response to Mycobacterium avium in cystic fibrosis (CF). Neutrophils in the presence of complement factors, including C3 and IgM, efficiently killed M. avium in healthy individuals, but CF patients had significantly lower killing efficiency. These findings contribute to our understanding of the immune response to M. avium and provide insights for improving diagnostic and treatment strategies.
MICROBIOLOGY SPECTRUM
(2023)
Article
Biochemistry & Molecular Biology
Alma E. Ochoa, Jack H. Congel, Jodi M. Corley, William J. Janssen, Jerry A. Nick, Kenneth C. Malcolm, Katherine B. Hisert
Summary: Mycobacterium abscessus is a pathogen that can cause pulmonary infections in people with chronic airway diseases. The study found that Dectin-1 can recognize M. abscessus, but blocking it does not affect the uptake of M. abscessus by macrophages. The study also found that besides Dectin-1, other receptors can also participate in the phagocytosis of M. abscessus.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Respiratory System
Nicole Mayer-Hamblett, David P. Nichols, Katherine Odem-Davis, Kristin A. Riekert, Greg S. Sawicki, Scott H. Donaldson, Felix Ratjen, Michael W. Konstan, Noah Simon, Daniel B. Rosenbluth, George Retsch-Bogart, John P. Clancy, Jill M. VanDalfsen, Rachael Buckingham, Alex H. Gifford
Summary: The study aims to evaluate whether the daily treatment burden can be reduced for individuals with cystic fibrosis receiving new triple-combination therapy, by comparing the effects of discontinuing versus continuing two commonly used chronic therapies.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2021)
Article
Respiratory System
Jonathan D. Cogen, Anna Faino, Frankline Onchiri, Ronald L. Gibson, Lucas R. Hoffman, Matthew P. Kronman, Margaret Rosenfeld, David P. Nichols
Summary: This study aimed to determine whether concomitant use of azithromycin (AZM) with intravenous tobramycin for pulmonary exacerbation (PEx) treatment is associated with worse clinical outcomes. The results suggested that concomitant use of AZM and intravenous tobramycin for in-hospital PEx treatment was associated with poorer clinical outcomes than treatment with intravenous tobramycin without AZM.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2021)