Effect of atropine on tracheal mucociliary clearance and bacterial counts

The purpose of this study was to determine if atropine, which has been shown to alter mucosal function, prolongs the persistence of inhaled bacteria in the trachea. In conscious sheep, bacterial counts in the trachea were determined by quantitative sterile brush cultures obtained before and serially after a controlled inhalation challenge, with an aerosolized solution containing P. hemolytica (10⁸ CFU · ml^-1). The same animals were studied on two days, once without (control day) and once before and during intramuscular administraion of 0.2 mg · kg^-1 atropine sulfate at hourly intervals for up to 10 h (atropine day). On the control and atropine days, bacterial counts were zero before, and between 5 x 10⁵ and 1.6 x 10⁷ CFU · ml^-1 immediately after inhalation of P. hemolytica. During the first 2 h after challenge, there was a similar semilogarithmic decline in bacterial counts on the control and atropine days despite the fact that mean tracheal mucociliary transport velocity remained unchanged on the control day, and ranged between 32% and 62% of baseline (p < 0.05) during the 6-10 h post-drug observation period on the atropine day. However, the time to achieve sterility on the control day was ≤ 8 h in all animals, and ≥ 8 h on the atropine day. We conclude that atropine prolongs the persistence of viable bacteria in the trachea. This effect of atropine may be related to an impairment of mucociliary clearance or to other alterations in mucosal function.