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Cystic fibrosis in the modern therapeutic era: Give the shower a thought!

Déborah Le Pennec1, Melisande Baravalle-Einaudi2, Christian Dupont3

  • 1INSERM U1100, Respiratory Diseases Centre, Tours University, Tours, France.

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|March 25, 2019
PubMed

Insights

Home use of e-flow rapid® meshes by cystic fibrosis patients led to significant defects in tobramycin delivery. A specialized cleaning system helped restore some defective meshes to expected performance levels.

Area of Science:

  • Medical device engineering
  • Pharmaceutical science
  • Respiratory medicine

Background:

  • Cystic fibrosis (CF) treatment often involves nebulized medications like tobramycin.
  • e-flow rapid® is a mesh nebulizer system used for drug delivery in CF patients.
  • Long-term performance and reliability of nebulizer components are crucial for effective treatment.

Purpose of the Study:

  • To characterize the tobramycin delivery performance of e-flow rapid® meshes after prolonged home use in cystic fibrosis patients.
  • To assess the impact of home use and cleaning protocols on mesh functionality.

Main Methods:

  • Fifty-two e-flow rapid® meshes were tested using laser diffractometry.
  • Meshes were characterized after 6 months of home use by CF patients on various nebulized therapies.
  • Defective meshes were identified based on tobramycin delivery parameters.

Main Results:

  • Out of 52 meshes, 3 were non-functional, and 30 were deemed defective for tobramycin delivery.
  • Utilizing a specific mesh cleaning shower system allowed 14 of the defective meshes to meet expected nebulized volume ranges.

Conclusions:

  • Prolonged home use of e-flow rapid® meshes can lead to a high rate of defects impacting tobramycin delivery.
  • A dedicated cleaning system shows potential in restoring the functionality of some defective meshes, improving drug delivery consistency.
Keywords:
Cystic fibrosisIn vitro studyMesh-nebulizerTobramycin

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