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Nebulized tobramycin: prevention of pneumonias in patients with severe cerebral palsy
Audrius V Plioplys1, Irene Kasnicka
1Marklund Children's Home, Bloomingdale, IL 60108, USA. plioplysav@sbcglobal.net
Insights
Intermittent nebulized tobramycin significantly reduced pneumonias and hospitalizations in severe cerebral palsy patients. This antibiotic therapy shows promise for preventing lung infections in this vulnerable population.
Area of Science:
- Pulmonary Medicine
- Pediatric Neurology
Background:
- Recurrent pneumonias are a significant cause of morbidity and mortality in severe cerebral palsy.
- Nebulized tobramycin is effective in managing lung infections in cystic fibrosis patients.
Observation:
- This study investigated the efficacy of intermittent nebulized tobramycin in three patients with severe cerebral palsy experiencing recurrent pneumonias.
- A comparison was made between the 12 months preceding treatment and the first 12 months of intermittent therapy.
Findings:
- The number of pneumonias decreased from 19 to 11 over the treatment year.
- Hospitalizations due to pneumonia and associated hospital days were reduced from 11 and 110 to 0, respectively.
Implications:
- Intermittent nebulized tobramycin may be a beneficial strategy for preventing pneumonias and hospitalizations in severe cerebral palsy patients.
- Further research is recommended to confirm these findings and establish optimal treatment protocols.
Background And Methods:
In patients with severe cerebral palsy, pneumonias are a frequent occurrence and can lead to excessive morbidity and mortality. Similar poor outcomes can occur in patients with cystic fibrosis. Nebulized tobramycin has been shown to be effective in preventing pneumonias, and in improving lung function in cystic fibrosis patients. This study reports results from three patients with severe cerebral palsy who were suffering from recurrent pneumonias. We compared the 12 months prior to starting nebulized tobramycin, to the first 12 months of intermittent therapy (28 days of nebulized antibiotic, followed by 28 days with no antibiotic, then repeated). We noted the number of pneumonias, the number of hospitalizations due to pneumonia, and length of hospitalizations for pneumonia.
Results:
Adding the results from the three patients together, the number of pneumonias went from 19 during the year prior to starting the nebulized tobramycin, to 11 during the year of treatment. The number of hospitalizations for pneumonia went from 11 to 0. The number of days in hospital for pneumonia went from 110 to 0.
Conclusion:
As in cystic fibrosis patients, patients with severe cerebral palsy may benefit from the intermittent use of nebulized tobramycin to prevent pneumonias and hospitalizations due to pneumonia. Further studies are warranted.
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