Randomised controlled trial of nebulised gentamicin in children with bronchiectasis.

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dc.contributor.author Twiss, Jacob
dc.contributor.author Stewart, Alistair
dc.contributor.author Gilchrist, Catherine A
dc.contributor.author Keelan, Jeffrey A
dc.contributor.author Metcalfe, Russell
dc.contributor.author Byrnes, Catherine A
dc.coverage.spatial Australia
dc.date.accessioned 2022-06-26T23:43:36Z
dc.date.available 2022-06-26T23:43:36Z
dc.date.issued 2022-02-16
dc.identifier.citation (2022). Journal of Paediatrics and Child Health.
dc.identifier.issn 1034-4810
dc.identifier.uri https://hdl.handle.net/2292/60139
dc.description.abstract Following trials of inhaled antibiotics in adults, this study investigates the efficacy of nebulised gentamicin to improve respiratory function in children with bronchiectasis. This is a randomised, double-blind, placebo-controlled, crossover trial of 12-week nebulised placebo/gentamicin, 6-week washout, 12-week gentamicin/placebo. Participants were children (5-15 years) with bronchiectasis, chronic infection (any pathogen), and able to perform spirometry from a hospital bronchiectasis clinic. Primary outcomes were change in forced expiratory volume in 1 s (FEV1 ) and hospitalisation days. Secondary outcomes included sputum bacterial density, sputum inflammatory markers, additional antibiotics and symptom severity. Analyses were on an intention-to-treat basis. Fifteen children (mean 11.7-years-old) completed the study. There was no significant change in mean FEV1 (56%/55%, P = 0.38) or annual rate of hospital admissions (1.1/0, P = 0.12) between gentamicin and placebo, respectively. However, Haemophilus influenzae sputum growth (27% vs. 80%, P = 0.002) and bacterial density (2.4 log10 cfu/mL lower P < 0.001) improved with gentamicin. Sputum inflammatory markers interleukin-1β (P < 0.001), interleukin-8 (P < 0.001) and tumour necrosis factor-α (P = 0.003) were lower with gentamicin. Poor recruitment limited study power and treatment adherence was challenging for this cohort. In this crossover study of nebulised gentamicin in children with bronchiectasis, there was a reduction in sputum bacterial density and inflammation. However, there were no major improvements in clinical outcomes and adherence was a challenge.
dc.format.medium Print-Electronic
dc.language eng
dc.publisher Wiley
dc.relation.ispartofseries Journal of paediatrics and child health
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.rights.uri https://creativecommons.org/licenses/by-nc/4.0/
dc.subject bronchiectasis
dc.subject child
dc.subject gentamicin
dc.subject inflammation
dc.subject nebulised antibiotic
dc.subject Pediatric
dc.subject Clinical Trials and Supportive Activities
dc.subject Lung
dc.subject Infectious Diseases
dc.subject Clinical Research
dc.subject 6.1 Pharmaceuticals
dc.subject Infection
dc.subject Respiratory
dc.subject Science & Technology
dc.subject Life Sciences & Biomedicine
dc.subject Pediatrics
dc.subject ADHERENCE
dc.subject 1103 Clinical Sciences
dc.subject 1114 Paediatrics and Reproductive Medicine
dc.subject 1117 Public Health and Health Services
dc.title Randomised controlled trial of nebulised gentamicin in children with bronchiectasis.
dc.type Journal Article
dc.identifier.doi 10.1111/jpc.15899
dc.date.updated 2022-05-26T02:19:56Z
dc.rights.holder Copyright: The author en
dc.identifier.pmid 35170144 (pubmed)
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/35170144
pubs.publication-status Published
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype IM
pubs.subtype Journal Article
pubs.elements-id 883326
pubs.org-id Medical and Health Sciences
pubs.org-id School of Medicine
pubs.org-id Paediatrics Child & Youth Hlth
dc.identifier.eissn 1440-1754
pubs.record-created-at-source-date 2022-05-26
pubs.online-publication-date 2022-02-16

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