• Chest · May 2009

    Randomized Controlled Trial Multicenter Study

    Efficacy and safety of inhaled aztreonam lysine for airway pseudomonas in cystic fibrosis.

    • George Z Retsch-Bogart, Alexandra L Quittner, Ronald L Gibson, Christopher M Oermann, Karen S McCoy, A Bruce Montgomery, and Peter J Cooper.
    • Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27599-7217, USA. gzrb@med.unc.edu
    • Chest. 2009 May 1;135(5):1223-32.

    BackgroundWe assessed the short-term efficacy and safety of aztreonam lysine for inhalation (AZLI [an aerosolized monobactam antibiotic]) in patients with cystic fibrosis (CF) and Pseudomonas aeruginosa (PA) airway infection.MethodsIn this randomized, double-blind, placebo-controlled, international study (AIR-CF1 trial; June 2005 to April 2007), patients (n = 164; >or= 6 years of age) with FEV(1) >or= 25% and ResultsAfter 28 days of treatment, AZLI improved the mean CFQ-R respiratory score (9.7 points; p < 0.001), FEV(1) (10.3% predicted; p < 0.001), and sputum PA density (- 1.453 log(10) cfu/g; p < 0.001), compared with placebo. Significant improvements in Eating, Emotional Functioning, Health Perceptions, Physical Functioning, Role Limitation/School Performance, and Vitality CFQ-R scales were observed. Adverse events were consistent with symptoms of CF lung disease and were comparable for AZLI and placebo except the incidence of "productive cough" was reduced by half in AZLI-treated patients. PA aztreonam susceptibility at baseline and end of therapy were similar.ConclusionsIn patients with CF, PA airway infection, moderate-to-severe lung disease, and no recent use of antipseudomonal antibiotics or azithromycin, 28-day treatment with AZLI significantly improved respiratory symptoms and pulmonary function, and was well tolerated.Trial RegistrationClinicaltrials.gov Identifier: NCT00112359.

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