Evaluation of jet nebulisers for use with gentamicin solution

Area of Science:

• Respiratory Medicine
• Pharmaceutical Technology
• Biomedical Engineering

Background:

• Nebulised antibiotics, including gentamicin and carbenicillin, show promise for treating respiratory infections in cystic fibrosis (CF).
• Limited data exists on optimal nebuliser selection and operational parameters for viscous antibiotic solutions.
• Previous clinical outcomes with antibiotic aerosols may be suboptimal due to equipment or operational factors.

Purpose of the Study:

• To evaluate aerosol output, droplet size, and nebulisation time for different jet nebulisers and operating conditions.
• To determine the most efficient nebuliser and settings for delivering respirable antibiotic particles.
• To provide guidance for optimizing antibiotic aerosol therapy in CF patients.

Main Methods:

• Four jet nebuliser brands (Bird, DeVilbiss, Inspiron, Upmist) were tested.
• Gentamicin solutions (2 ml/80 mg and 4 ml/160 mg) were nebulised.
• Compressed gas flow rates varied from 6 to 12 L/min.

Main Results:

• Significant variations in aerosol output and droplet size were observed among nebulisers.
• DeVilbiss and Upmist nebulisers demonstrated higher efficiency in producing respirable droplets (<5 micron).
• Higher gas flow rates and increased fill volumes generally improved aerosol output but increased nebulisation time.

Conclusions:

• Optimal delivery of gentamicin aerosol requires careful selection of nebuliser (e.g., DeVilbiss, Upmist) and operating parameters.
• A fill volume of 4 ml at flow rates of 10-12 L/min or using a high-flow compressor is recommended for efficient drug delivery.
• Incorrect nebuliser choice or settings may contribute to suboptimal clinical results in antibiotic aerosol therapy.