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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2005 December;44(4):141-78
Topical mucolysis and antibiotic therapy in chronic diseases of airways with focus on cystic fibrosis
Melillo G., Passali D., Melillo E.
Qualitative and quantitative alterations of mucus can provoke and/or influence various diseases of the upper and lower airways. In order to prevent or limit such events, 2 strategies can be adopted: the mucolytic treatment and the antibiotic therapy. We refer to mucolysis which can be obtained by inhalatory administration of some tiolic mucolytics (i.e., having a free sulphidril group), such as N-acetylcysteine and sodium 2-mercaptoethane sulphidric, drugs endowed with an intense and rapid topical action. As typical disease, reference is made to cystic fibrosis, being probably the most typical situation of increased steady secretions and subsequent chronic airway inflammation causing marked symptoms of both lower and upper airways. Moreover, such disease requires chronic antibiotic therapy against Pseudomonas aeruginosa. Therapy is carried out by administering a tobramycin, adapted for inhalation, alternating 4 weeks of treatment and 4 treatment-free weeks. The observations regarding cystic fibrosis are obviously valid for other chronic airway diseases, such as bronchiectasis, purulent bronchitis, rhinosinusitis, otitis etc.