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August 1985, Vol 139, No. 8 >
Article | August 1985

Edetate Sodium Aerosol in Pseudomonas Lung Infection in Cystic Fibrosis FREE

John Brown, MB, BS, FRACP; Craig M. Mellis, MB, BS, FRACP; Robert E. Wood, PhD, MD
[+] Author Affiliations

Presented in part before the Ninth International Cystic Fibrosis Congress, Brighton, England, June 11-15, 1984.

Reprints not available.


Am J Dis Child. 1985;139(8):836-839. doi:10.1001/archpedi.1985.02140100098043.
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• In vitro and animal experimental data suggest the combination of edetate sodium (EDTA) by aerosol plus oral antimicrobials might be effective in the treatment of chronic Pseudomonas infection in patients with cystic fibrosis (CF). For six months we studied the effects of edetate sodium administered by ultrasonic nebulizer to ten children with CF and chronic Pseudomonas aeruginosa infection in a double-blind, placebo-controlled, crossover study. The children had evidence of mild to moderate disease at entry in the study, with a mean (±SD) forced expiratory volume in the first second of 85% (±18%0 of the predicted value and a mean (± SD) Shwachman-Kulczycki score of 83 (±7)/100. Each child was on a three-month regimen of aerosolized edetate sodium plus oral tetracycline twice daily followed by three months of placebo aerosol plus tetracycline or vice versa. Progress was assessed by measurement of pulmonary function, physical examination, and sputum cultures at four weekly intervals, plus chest roentgenograms on entry and after each of the three-month treatment periods. Daily symptoms were assessed using a diary card system. Two patients could not complete the study, one because of severe respiratory relapse, the other because of antibiotic side effects. Of the remaining eight patients, none showed any improvement in pulmonary function, weight gain, or growth acceleration, and none was rendered free of Pseudomonas lung infection. Daily symptom scores and chest roentgenograms were unaltered by edetate sodium. We conclude that the combination of aerosol edetate sodium plus oral tetracycline over a three-month period does not modify the clinical course nor the pulmonary flora in patients with CF with chronic Pseudomonas lung infection.

(AJDC 1985;139:836-839)

REFERENCES

1 +
Kulczycki LL, Murphy TM, Bellanti JA:  Pseudomonas colonization in cystic fibrosis: A study of 160 patients . JAMA 1978;;240:30-34.
2 +
Henry RL, Dorman DC, Brown J, et al:  Mucoid Pseudomonas aeruginosa in cystic fibrosis . Aust Paediatr J 1982;;18:43-45.
3 +
Wood RE, Boat TF, Doershuk CF:  State of the art: Cystic fibrosis . Am Rev Respir Dis 1976;;113:833-878.
4 +
Høiby N:  Microbiology of lung infections in cystic fibrosis patients . Acta Paediatr Scand 1982;;( (suppl 301) )33-54.
5 +
Sanders CC:  Inducible β-lactamases and non-hydrolytic resistance mechanisms . J Antimicrob Chemother 1984;;13:1-3.
6 +
Wood RE, Klinger JD, Thomassen MJ, et al:  The effect of EDTA and antibiotics on Pseudomonas aeruginosa isolated from cystic fibrosis patients: A new chemotherapeutic approach , in Sturgess JM (ed): Perspectives in Cystic Fibrosis: Proceedings From the Eighth International Cystic Fibrosis Congress . Toronto, Canadian Cystic Fibrosis Foundation, 1980;, pp 365-369.
7 +
Norman AP: Technique for analysis and assessment of radiographs. Read before the European Working Group on Cystic Fibrosis, London, June 21-22, 1971.
8 +
Dixon WJ, Massey FJ: Introduction to Statistical Methods , ed 3. New York, McGraw-Hill Book Co, 1969;, pp 109-126.
9 +
Weiser R, Asscher AW, Wimpenny J:  Invitro reversal of antibiotic resistance by EDTA . Nature 1968;;219:1365-1366.
10 +
Ashbell MA, Eagon RG:  Role of multivalent cations in the organisation, structure and assembly of the cell wall of Pseudomonas aeruginosa . J Bacteriol 1966;;92:380-387.
11 +
Blue JL, Wooley RE, Eagon RG:  Treatment of experimentally induced Pseudomonas aeruginosa otitis externa in the dog: Lavage with EDTA–tromethamine lysozyme . Am J Vet Res 1974;;35:1221-1223.
12 +
Goldschmidt MD, Kuhn CR, Perry K, et al:  EDTA and lysozyme lavage in the treatment of Pseudomonas and coliform bladder infections . J Urol 1972;;107:969-972.
13 +
Petrovic LJ, Stankovic M, Saviecevic M, et al:  Aerosol inhalation of CaNa2 EDTA (Mosatil) by workers constantly exposed to lead poisoning . Br J Ind Med 1972;;17:201-204.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Kulczycki LL, Murphy TM, Bellanti JA:  Pseudomonas colonization in cystic fibrosis: A study of 160 patients . JAMA 1978;;240:30-34.
2 +
Henry RL, Dorman DC, Brown J, et al:  Mucoid Pseudomonas aeruginosa in cystic fibrosis . Aust Paediatr J 1982;;18:43-45.
3 +
Wood RE, Boat TF, Doershuk CF:  State of the art: Cystic fibrosis . Am Rev Respir Dis 1976;;113:833-878.
4 +
Høiby N:  Microbiology of lung infections in cystic fibrosis patients . Acta Paediatr Scand 1982;;( (suppl 301) )33-54.
5 +
Sanders CC:  Inducible β-lactamases and non-hydrolytic resistance mechanisms . J Antimicrob Chemother 1984;;13:1-3.
6 +
Wood RE, Klinger JD, Thomassen MJ, et al:  The effect of EDTA and antibiotics on Pseudomonas aeruginosa isolated from cystic fibrosis patients: A new chemotherapeutic approach , in Sturgess JM (ed): Perspectives in Cystic Fibrosis: Proceedings From the Eighth International Cystic Fibrosis Congress . Toronto, Canadian Cystic Fibrosis Foundation, 1980;, pp 365-369.
7 +
Norman AP: Technique for analysis and assessment of radiographs. Read before the European Working Group on Cystic Fibrosis, London, June 21-22, 1971.
8 +
Dixon WJ, Massey FJ: Introduction to Statistical Methods , ed 3. New York, McGraw-Hill Book Co, 1969;, pp 109-126.
9 +
Weiser R, Asscher AW, Wimpenny J:  Invitro reversal of antibiotic resistance by EDTA . Nature 1968;;219:1365-1366.
10 +
Ashbell MA, Eagon RG:  Role of multivalent cations in the organisation, structure and assembly of the cell wall of Pseudomonas aeruginosa . J Bacteriol 1966;;92:380-387.
11 +
Blue JL, Wooley RE, Eagon RG:  Treatment of experimentally induced Pseudomonas aeruginosa otitis externa in the dog: Lavage with EDTA–tromethamine lysozyme . Am J Vet Res 1974;;35:1221-1223.
12 +
Goldschmidt MD, Kuhn CR, Perry K, et al:  EDTA and lysozyme lavage in the treatment of Pseudomonas and coliform bladder infections . J Urol 1972;;107:969-972.
13 +
Petrovic LJ, Stankovic M, Saviecevic M, et al:  Aerosol inhalation of CaNa2 EDTA (Mosatil) by workers constantly exposed to lead poisoning . Br J Ind Med 1972;;17:201-204.

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