Document Detail

Antipseudomonal therapy in cystic fibrosis: aztreonam and amikacin versus ceftazidime and amikacin administered intravenously followed by oral ciprofloxacin.
MedLine Citation:
PMID:  2512129     Owner:  NLM     Status:  MEDLINE    
In order to determine the optimal antipseudomonal therapy in patients with cystic fibrosis aztreonam plus amikacin was compared to ceftazidime plus amikacin, and these two-week hospital regimens were followed by oral ciprofloxacin given for four weeks. Fifty-six cases of acute pulmonary exacerbation of the disease in 42 patients associated with isolation of Pseudomonas aeruginosa from the sputum were randomly treated with either aztreonam or ceftazidime (300mg/kg/day i.v.; maximum daily dose 12g) in combination with amikacin (36mg/kg/day i.v.; maximum daily dose 1,500mg). Other aspects of the two-week treatment were constant. The two therapy groups were comparable in all respects. Both regimens were well tolerated and resulted in similar improvements in clinical, bacteriologic, radiologic and laboratory findings, and pulmonary function. Fifty patients could be reevaluated after subsequent outpatient therapy consisting of oral ciprofloxacin (30mg/kg/day; maximum daily dose 1,500mg) given for four weeks. During this period, the clinical and laboratory improvements persisted, and the rate of eradication of Pseudomonas aeruginosa from sputum decreased from 62% to 34%. Ciprofloxacin was well tolerated and there was no drug toxicity or serious adverse effect. In the 25 prepubertal patients there was neither subjective nor objective evidence of skeletal drug toxicity. In patients with cystic fibrosis, aztreonam or ceftazidime in combination with amikacin represents an effective and safe systemic anti-pseudomonal therapy. Subsequent oral ciprofloxacin therapy for four weeks prolongs the beneficial effects and is well tolerated.
U B Schaad; J Wedgwood-Krucko; K Guenin; U Buehlmann; R Kraemer
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  8     ISSN:  0934-9723     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1990-01-25     Completed Date:  1990-01-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  858-65     Citation Subset:  IM    
Department of Pediatrics, Inselspital, University of Berne, Switzerland.
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MeSH Terms
Amikacin / administration & dosage
Aztreonam / administration & dosage
Ceftazidime / administration & dosage
Child, Preschool
Ciprofloxacin / administration & dosage
Cystic Fibrosis / complications*
Drug Therapy, Combination / administration & dosage*
Pseudomonas Infections / complications,  drug therapy*
Randomized Controlled Trials as Topic
Reg. No./Substance:
37517-28-5/Amikacin; 78110-38-0/Aztreonam; 78439-06-2/Ceftazidime; 85721-33-1/Ciprofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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