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Disposable jetnebulizers

Question
Hello,
Our 19 year old daughter uses the PARI BOY with disposable kits for PULMOZYME, colistin and TOBI.
Our service provider recommends us (on the advice of EMERA network) to stop using disposable kits and use a device that should be sterilized every day, why?
In her student life, this is not manageable, disposable kits are so simple to use ... Are there any differences in efficacy of treatment?
Thank you for your response.
Answer
hello
The response of EMERA network is based on a very interesting study by specialists of inhaled therapies in cystic fibrosis (Vecellio L, et al. Disposable versus reusable jet nebulizers for cystic fibrosis treatment with tobramycin. Journal of Cystic Fibrosis, 2011, 10:86 -92). This study shows that the inhalable mass of TOBI is very different depending on the devices used. This is important because the efficacy of an antibiotic depends on the dose; and some nebulizers provide only a very low antibiotic deposition in the lungs.
The second interesting information in this study is that the reusable Pari LC Plus nebulizer produces an inhalable mass greater than that obtained with most disposable nebulizers used in CF centers.
Among the disposable nebulizers suitable for TOBI, the NL9M nebulizer (disposable with the NL9MU label) coupled to an Abox compressor and the Sidestream 4452U nebulizer used with Portaneb should be mentioned.
Indeed, we must not underestimate the daily constraint of nebulization and cleaning devices (10-15 minutes twice a day for nebulization, 5 minutes twice a day for cleaning and 10 minutes for disinfection). Therefore, it is important to assess the situation with the patient on its inhaled therapy (prescribed medications, equipment used, method of disinfection, compliance) and seek how to optimize treatment.
If the patient is totally recalcitrant to cleaning of his devices, once informed, he has the right to choose. It is better to accept less deposition of antibiotics in the bronchi than no treatment at all because of excessive constraints.

Dr. Dominique Hubert

26.10.2015