Aztreonam helps preserve lung function with bacterial infections

Outcomes shown from 52 people with CF, chronic P. aeruginosa infections

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Treatment with the inhaled antibiotic aztreonam can stabilize lung function in people with cystic fibrosis (CF) who have chronic infections of the bacterium Pseudomonas aeruginosa.

That’s according to “Inhaled aztreonam lysine in the management of Pseudomonas aeruginosa in patients with cystic fibrosis: real-life effectiveness,” which was published in the European Journal of Hospital Pharmacy.

In cystic fibrosis, mutations in the CFTR gene cause the protein it provides cells with instructions for making to be dysfunctional or missing. As a result, cells are unable to regulate the flow of salt and water, which results in thick and sticky mucus being produced.

People with CF are at risk of chronic lung infections. The bacterium P. aeruginosa is a major agent of chronic CF lung infections. Aztreonam may be used to treat Pseudomonas infections in CF.

In this study, scientists reported outcomes from 52 people with CF and chronic P. aeruginosa infections who were treated with aztreonam at one of three hospitals in Spain.

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Treatment of aztreonam for chronic infection

The patients’ lung function was measured using forced expiratory volume in one second (FEV1), a standard measure based on how much air someone can blow out in a short, forceful breath. FEV1 was stable over a year of treatment on aztreonam, results showed. At the start of treatment, the average FEV1 was 55.6% and after a year it was 56.8%.

Patients treated with aztreonam had significantly fewer exacerbations (times lung function suddenly worsens, usually due to infection). In the year before starting aztreonam, the median number of exacerbations was two. In the first year on the inhaled antibiotic, the number dropped to one.

“In patients with CF and chronic P. aeruginosa infection receiving [aztreonam], stabilisation of lung function measured by FEV1 was observed after [one] year of follow-up. In addition, a significant decrease in the rate of exacerbations was demonstrated,” the researchers wrote.

Patients also tended to gain weight in the first year of treatment, with the average weight increasing from 49.5 kg (about 109 pounds) to 51.5 kg (about 113 pounds). The use of other antibiotics decreased significantly in the first year on aztreonam — from five to four — while rates of hospitalizations didn’t significantly change.

Safety data showed aztreonam was generally well tolerated, with just six of the 52 patients reporting any notable side effects from treatment. Two patients discontinued the medication due to side effects that included worsening cough and coughing up blood.

The researchers emphasized that their analysis was limited to a few dozen patients, but said the data highlight that inhaled aztreonam can help stabilize lung function in people with CF who have chronic Pseudomonas infections.