Alternative antibiotics for the treatment of pseudomonas infections in cystic fibrosis

Mastella, G; Agostini, Mark; Barlocco, G.; Bonomi, U; Borgo, G; Bozzino, L.; Cabrini, Giulio; Cappelletti, Leonardo; Castellani, L; Conforti, M.; Marazzani, S.; Martini, Nello; Montemezzi, Pietro; Paulon, G.; Pederzini, Fabio; Sancassani, L.; Scroccaro, Giovanna

doi:10.1093/jac/12.suppl_a.297

Cited by 33 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Firstly, resistance to ureido-penicillin is increasing. Resistance to ticarcillin has increased to 62% in some studies [60], whereas resistance to cephalosporins, such as ceftazidime, is currently appreciably lower [59]. Secondly, aminoglycosides are potentially oto-and nephrotoxic [71].…”

Section: General Considerationsmentioning

confidence: 99%

Cystic fibrosis, pathophysiological and clinical aspects

et al. 1990

View full text Add to dashboard Cite

Cystic fibrosis is a lethal, hereditary, until recently little understood disease, which leads to progressive functional disturbances in various organs, including the lungs, liver and pancreas. Knowledge of the genetic and cellular abnormalities is rapidly progressing, but therapy is still symptomatic and based on insufficiently controlled and short-term studies. At present the therapeutic approach aims to combat respiratory infections by optimal antibiotic therapy, combined with techniques to promote sputum evacuation. Additional measures attempt to optimise both nutritional state and physical condition. Median survival has improved from approximately 1 year to about 25 years during the past 3 decades. This article summarises present information on disease mechanisms and treatment.

show abstract

Section: General Considerationsmentioning

confidence: 99%

Cystic fibrosis, pathophysiological and clinical aspects

et al. 1990

View full text Add to dashboard Cite

show abstract

“…The drugs may substantially reduce the population of organisms in the lung without completely eradicating them, as has been shown in previous trials. 7 Another explanation is that in some patients the lungs may be sterilised during the course of treatment but that recolonisation occurs after this. Intravenous ceftazidime appears to be a promising treatment for patients with cystic fibrosis and pulmonary pseudomonas infections who develop acute exacerbations of their respiratory symptoms.…”

Section: Discussionmentioning

confidence: 99%

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.

1985

Thorax

View full text Add to dashboard Cite

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.

show abstract

“…In recent years resistance to ticarcillin has increased to 62% in some studies (33). Resistance to cephalosporins, such as ceftazidime, is currently appreciably lower than that to broad spectrum penicillins (34). Secondly, toxicity of aminoglycosides has to be considered which may involve the kidney and the ear (35).…”

Section: Treatment Of Pseudomonasmentioning

confidence: 99%

Strategies and Perspectives in Treatment of Respiratory Infections

1989

Acta Paediatrica

View full text Add to dashboard Cite

Neijens, H. J. (Department of Paediatrics, Sophia Children's Hospital, Gordelweg 160, 3038 GE Rotterdam, The Netherlands). Strategies and perspectives in treatment of respiratory infections. Acta Paediatr Scand Suppl 363: 66, 1989.Bronchopulmonary infections in CF have a number of special features. The pathophysiology is determined by consequences of the basic CF defect and interactions with host defence systems, leading to chronic innammation Induced by Staphylococci and subsequently Pseudomonas. This results in lung tissue damage, wrious complications and eventually respiratory insufficiency. Policy of treatment is to combat infectious exacerbations and lung tissue destruction as much as possible. Factors in optimal treatment such as strategies, Indications for therapy and selection of antibiotics are discussed.

show abstract

Alternative antibiotics for the treatment of pseudomonas infections in cystic fibrosis

Cited by 33 publications

References 0 publications

Cystic fibrosis, pathophysiological and clinical aspects

Cystic fibrosis, pathophysiological and clinical aspects

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.

Strategies and Perspectives in Treatment of Respiratory Infections

Contact Info

Product

Resources

About