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In vitro evaluation of aerosol delivery of aztreonam lysine (AZLI): an adult mechanical ventilation model

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Version 2 2017-10-23, 12:24
Version 1 2017-10-18, 08:00
journal contribution
posted on 2017-10-23, 12:24 authored by Alejandro Rodríguez, María Cabrera, Luis F. Reyes, María Bodí, Sandra Trefler, Laura Canadell, Diego Barahona, Stepham Ehrmann, Ignacio Martin-Loeches, Marcos I. Restrepo, Laurent Vecellio

Background: The delivery profile of Aztreonam lysine (AZLI) during mechanical ventilation (MV) is unknown. We evaluated the amount of AZLI drug delivered using an in vitro model of adult MV.

Methods: An adult lung model designed to mimic current clinical practice was used. Both nebulizers were placed before a Y-piece and 4 settings were tested: A) Aeroneb solo® [AS] with a t-piece; B) AS with the spacer; C) M-Neb® [MN] with a t-piece and D) MN with the spacer. Performance was evaluated in terms of: 1) Mass median aerodynamic diameter (MMAD); 2) Geometric standard deviation (GSD), 3) Fine particle dose (FPD), 4) Fine particle fraction (FPF), 5) Inhalable mass (IM), and 6) Recovery rate (RR).

Results: Both devices showed an adequate delivery of AZLI during MV, with MMAD between 2.4–2.5 µm and 87% of FPF. The FPD (38.8 and 31.7), IM (44.8 and 36.1) and RR (30 and 24) were similar for AS and MN respectively. Nebulizer aerosol delivery increased (50 and 70% respectively) for both nebulizers when using the spacer.

Conclusion: Both AS and MN showed a good aerosol delivery profile for AZLI during in vitro mechanical ventilation. Better aerosol delivery performance was obtained using the spacer.

Funding

This study was supported by grants from Gilead Science.

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