Cayston® (Aztreonam lysine)

Question

Hello CF team,

[Germany related part of the question about the availability]

How is the treatment with the inhalative antbiotic drug Cayston® (Aztreonam lysine)?

1st month: Colistin
2nd month: Tobi® (tobramycine)
3rd month: Aztreonam lysine and then start again from the beginning?

Many thanks.

Answer

Hello,

Many thanks for your question. I would answer as follows:

[Germany related part of answer regarding availability]

In Germany, for the time being Aztreonam lysine has been approved for a therapy duration of a 28-day cycle. According to the summary of product characteristics further cycles are only to be considered according to the doctor’s decretion. In this case it is recommended to have a least a period of 28 days without treatment with Aztreonam lysine. The approval was only given on condition that further studies e.g. about long-term treatment, a comparison of Aztreonam lysine/Tobramycine and about the treatment in children will follow. So far there are no clinical studies where the sequential or simultaneous combined treatment of Aztreonam with other inhaled antibiotics was analysed systematically. It has to be mentioned that in one of the approval studies the patients were pre-treated with Tobramycine and in the following studies a great part of the patients received Colistine and Tobramycine additionally. The results have not been published so that a combined therapy has to be done according to the medical doctor’s decretion. The order you suggest (Colistine->Tobramycine->Aztreonam lysine) is certainly one of the possibilities.

Best regards,
Dr. Stefan Blaas

23.06.2010