CFDB - Cystic Fibrosis DataBase

primary studies published, non RCT

Use of taurolidine in lung transplantation for cystic fibrosis and impact on bacterial colonization.

Study design (if review, criteria of inclusion for studies)

Observational study

Participants

114 CF patients who underwent lung transplantation between 2007 and 2013

Interventions

Taurolidine 2% bronchial lavage was applied in a substantial proportion of patients (n = 42).

Outcome measures

A detailed analysis of donor and recipient bacterial colonization status in treatment and control groups and their impact on outcome was performed.

Main results

The proportion of recipients colonized with Pseudomonas aeruginosa was lower in the taurolidine group at 3 months (P < 0.001) and at 1 year (P = 0.053) postoperatively, despite no differences before transplant (P = 1.000). Moreover, a complete eradication of Burkholderia cepacia and Stenotrophomonas maltophilias colonizations could be achieved in the taurolidine group, whereas in the non-taurolidine group, persistent B. cepacia and S. maltophilias colonizations were observed. Early outcome in the taurolidine group was superior regarding fraction of expired volume in 1 s at 3 and 6 months after surgery with 74.5 +/- 14.6 vs 60.4 +/- 17.5 (P < 0.001) and 80.6 +/- 16.9 vs 67.2 +/- 19.4 (P = 0.005) percent of predicted values, respectively. In terms of long-term overall survival (P = 0.277) and freedom from bronchiolitis obliterans syndrome (P = 0.979), both groups were comparable.

Authors' conclusions

Taurolidine might be associated with a reduced proportion of CF patients colonized with multiresistant pathogens, particularly with P. aeruginosa. Long-term results should be further assessed in larger multicentre trials.

Related topics

Keywords: Anti-Bacterial Agents; Bacterial Infections; Infection; Inhalation OR nebulised; nebuliser; non pharmacological intervention - devices OR physiotherapy; pharmacological_intervention; Respiratory Tract Diseases; Respiratory Tract Infections; taurolidine; Amino Acids; Proteins; Lung Transplantation; non pharmacological intervention - surg; Respiratory Insufficiency; transplantation;