nebulisers in patients with cystic fibrosis

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Subject: HaloLite and the Pari LC Plus nebulisers in patients with cystic

fibrosis

Archives of Disease in Childhood 2003;88:715-718

© 2003 BMJ Publishing Group & Royal College of Paediatrics and Child

Health

Comparison of lung deposition of colomycin using the HaloLite and the

Pari LC Plus nebulisers in patients with cystic fibrosis

N M Byrne1, P M Keavey2, J D 3, F K Gould3 and D A Spencer1 1

Regional Paediatric Cystic Fibrosis Unit, Newcastle upon Tyne Hospitals

NHS Trust, UK

2 Regional Medical Physics Department, Newcastle upon Tyne Hospitals NHS

Trust

3 Microbiology Department, Newcastle upon Tyne Hospitals NHS Trust

Correspondence to:

Mrs N Byrne, Rehabilitation Department, Royal Infirmary, Queen

Road, Newcastle upon Tyne NE1 4LP, UK;

nuala.byrne@...: To examine the effectiveness of

delivery of nebulised colistin by the HaloLite nebuliser compared to the

Pari LC Plus in patients with cystic fibrosis. Methods: Randomised

crossover trial of 15 patients aged >6 years. Inhalation of one mega unit

of colistin in 3 ml diluent, labelled with technetium-99m DTPA, was used

to assess lung deposition. The Pari was nebulised to dryness and one

button press of the HaloLite was completed. Following a seven day washout

period, patients inhaled colistin twice daily for seven days through the

first device. Sputum specimens were analysed for colistin levels and

pseudomonas load. This procedure was repeated with the alternative

device. Results: Lung uptake of radiolabelled colistin was significantly

higher with the Pari. However, lung uptake calculated as a percentage of

the amount of drug used was significantly higher for the HaloLite. Time

to nebulise was significantly shorter with the HaloLite. Sputum levels of

colistin were higher following use of the Pari; this was close to

significance. Conclusion: The manufacturer's recommended dosages for

nebulising antibiotics with a HaloLite result in a lower delivery than

patients receive when using a Pari nebuliser. The concept of adaptive

aerosol delivery has several theoretical advantages but the recommended

doses for the HaloLite need to be modified in order to improve

effectiveness. Keywords: cystic fibrosis; colistin; HaloLite; Pari LC

Plus

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