Inhaled amiloride and tobramycin solutions fail to eradicate Burkholderia dolosa in patients with cystic fibrosis

• Published in: Journal of cystic fibrosis 2013-01, Vol.12 (1), p.54-59
• Main Authors: Uluer, Ahmet Z, Waltz, David A, Kalish, Leslie A, Adams, Summer, Gerard, Craig, Ericson, Dawn A
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Amiloride; Amiloride - administration & dosage; Anti-Bacterial Agents - therapeutic use; Burkholderia cepacia complex; Burkholderia dolosa; Burkholderia Infections - drug therapy; Chronic Disease; Cystic fibrosis; Drug Synergism; Drug Therapy, Combination; Endpoint Determination; Humans; Pulmonary/Respiratory; Tobramycin; Tobramycin - administration & dosage; Treatment Failure
• ISSN: 1569-1993; 1873-5010
• DOI: 10.1016/j.jcf.2012.06.006

Abstract Background Burkholderia dolosa can result in chronic airway infection and rapid decline in lung function in patients with cystic fibrosis (CF). Amiloride has antibacterial properties that may be synergistic with aminoglycosides against other species belonging to the Burkholderia cepacia complex (Bcc). We attempted to eradicate B. dolosa using a combination of nebulized tobramycin and nebulized amiloride in infected CF patients. Methods A 6-month, open-label trial of continuous inhaled amiloride, delivered via nebulization four times daily, and continuous inhaled tobramycin (TIS or TOBI®) nebulized twice daily, was offered to all CF patients at our institution who are chronically infected with B. dolosa. Results Twenty two of 27 patients with B. dolosa were eligible and twelve elected to participate. Eradication of B. dolosa was not noted in any study subject. While patients tolerated treatment with no adverse effects, there was also no apparent impact on other secondary outcome measures. Conclusions Concurrent, continuous inhalation of amiloride and tobramycin for 6 months was not effective for the eradication of chronic B. dolosa airway infection in CF patients.