Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1985 May;40(5):358–363. doi: 10.1136/thx.40.5.358

Ceftazidime compared with gentamicin and carbenicillin in patients with cystic fibrosis, pulmonary pseudomonas infection, and an exacerbation of respiratory symptoms. British Thoracic Society Research Committee.

PMCID: PMC460067  PMID: 2862713

Abstract

An open randomised comparison of a new intravenous cephalosporin, ceftazidime, with the established regimen of gentamicin and carbenicillin was carried out in patients with cystic fibrosis who had persisting pulmonary infection with Pseudomonas species and who developed acute exacerbations of respiratory symptoms. Fifty patients received ceftazidime and 32 gentamicin and carbenicillin. The ceftazidime and gentamicin were given every eight hours and the carbenicillin every six hours. The mean total daily doses were 151 mg/kg for ceftazidime, 6.3 mg/kg for gentamicin and 450 mg/kg for carbenicillin. The mean duration of treatment was 10 days in patients receiving gentamicin and carbenicillin and 12 days in those receiving ceftazidime. Of the patients with pseudomonas in the initial sputum specimen in whom sputum was cultured after treatment, six (26%) of 23 receiving gentamicin and carbenicillin and seven (18%) of 39 receiving ceftazidime had sputum free from pseudomonas at the end of treatment, but recolonisation occurred subsequently. In those receiving ceftazidime all 10 coexisting organisms were eliminated, whereas only four of seven coexisting organisms in patients receiving gentamicin and carbenicillin were eliminated. Overall clinical improvement occurred in 25 (78%) of 32 patients treated with gentamicin and carbenicillin and 48 (96%) of 50 patients treated with ceftazidime. Nineteen (59%) of the patients receiving gentamicin and carbenicillin but only 15 (30%) of those receiving ceftazidime required admission to hospital or intravenous antibiotics, or both, or died during the three months after treatment. Side effects in both groups were similar, mild, and infrequent. Thrombophlebitis occurred in four patients treated with gentamicin and carbenicillin but in no patients treated with ceftazidime.

Full text

PDF
363

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beaudry P. H., Marks M. I., McDougall D., Desmond K., Rangel R. Is anti-Pseudomonas therapy warranted in acute respiratory exacerbations in children with cystic fibrosis? J Pediatr. 1980 Jul;97(1):144–147. doi: 10.1016/s0022-3476(80)80155-7. [DOI] [PubMed] [Google Scholar]
  2. Davis S. D., Bruns W. T. Effects of sputum from patients with cystic fibrosis on the activity in vitro of 5 antimicrobial drugs on Pseudomonas aeruginosa. Am Rev Respir Dis. 1978 Jan;117(1):176–178. doi: 10.1164/arrd.1978.117.1.176. [DOI] [PubMed] [Google Scholar]
  3. Hodson M. E., Wingfield H. J., Batten J. C. Tobramycin and carbenicillin compared with gentamicin and carbenicillin in the treatment of infection with Pseudomonas aeruginosa in adult patients with cystic fibrosis. Br J Dis Chest. 1983 Jan;77(1):71–77. [PubMed] [Google Scholar]
  4. Kercsmar C. M., Stern R. C., Reed M. D., Myers C. M., Murdell D., Blumer J. L. Ceftazidime in cystic fibrosis: pharmacokinetics and therapeutic response. J Antimicrob Chemother. 1983 Jul;12 (Suppl A):289–295. doi: 10.1093/jac/12.suppl_a.289. [DOI] [PubMed] [Google Scholar]
  5. Kulczycki L. L., Murphy T. M., Bellanti J. A. Pseudomonas colonization in cystic fibrosis. A study of 160 patients. JAMA. 1978 Jul 7;240(1):30–34. [PubMed] [Google Scholar]
  6. Mastella G., Agostini M., Barlocco G., Bonomi U., Borgo G., Bozzino L., Cabrini G., Cappelletti L. M., Castellani L., Conforti M. Alternative antibiotics for the treatment of Pseudomonas infections in cystic fibrosis. J Antimicrob Chemother. 1983 Jul;12 (Suppl A):297–311. doi: 10.1093/jac/12.suppl_a.297. [DOI] [PubMed] [Google Scholar]
  7. Møller N. E., Eriksen K. R., Feddersen C., Flensborg E. W., Høiby N., Norn S., Rosendal K., Schiøtz P. O., Skov P. S. Chemotherapy against Pseudomonas aeruginosa in cystic fibrosis. A study of carbenicillin, azlocillin or piperacillin in combination with tobramycin. Eur J Respir Dis. 1982 Mar;63(2):130–139. [PubMed] [Google Scholar]
  8. O'Callaghan C. H., Acred P., Harper P. B., Ryan D. M., Kirby S. M., Harding S. M. GR 20263, a new broad-spectrum cephalosporin with anti-pseudomonal activity. Antimicrob Agents Chemother. 1980 May;17(5):876–883. doi: 10.1128/aac.17.5.876. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Penketh A., Hodson M. E., Gaya H., Batten J. C. Azlocillin compared with carbenicillin in the treatment of bronchopulmonary infection due to Pseudomonas aeruginosa in cystic fibrosis. Thorax. 1984 Apr;39(4):299–304. doi: 10.1136/thx.39.4.299. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Scribner R. K., Marks M. I., Weber A. H., Tarpay M. M., Welch D. F. Activities of various beta-lactams and aminoglycosides, alone and in combination, against isolates of Pseudomonas aeruginosa from patients with cystic fibrosis. Antimicrob Agents Chemother. 1982 Jun;21(6):939–943. doi: 10.1128/aac.21.6.939. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Strandvik B., Malmborg A. S., Alfredson H., Ericsson A. Clinical results and pharmacokinetics of ceftazidime treatment in patients with cystic fibrosis. J Antimicrob Chemother. 1983 Jul;12 (Suppl A):283–287. doi: 10.1093/jac/12.suppl_a.283. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES