BACKGROUND:Cystic fibrosis (CF) is characterized by chronic bacterial broncho-pulmonary infection. Although intravenous (i.v.) antibiotic therapy is regarded as standard treatment in CF, only few randomised trials comparing different antibiotic compounds exist. METHODS: We report on a prospective multicenter interventional trial of i.v. meropenem (120 mg/kg/day) or i.v. ceftazidime (200-400 mg/kg/day), each administered together with i.v. tobramycin (9-12 mg/kg/day). Outcome measures were changes in lung function, microbiological sputum burden and blood inflammatory marker. Liver and renal function values were measured to assess safety. RESULTS:One hundred eighteen patients (59/59) were included into the study with the following indications: first infection of P. aeruginosa (n=6), acute pulmonary exacerbation (n=34) and suppression therapy of chronic P. aeruginosa colonization (n=78). Both treatments improved lung function measures, bacterial sputum burden and CRP levels with no differences between treatment groups observed. A significant higher elevation for alkaline phosphatase (p<0.0001) was observed for patients in the meropenem/tobramycin group. CONCLUSIONS: i.v. antibiotic therapy in CF patients withmeropenem/tobramycin is as effective as with ceftazidime/tobramycin regarding lung function, microbiological sputum burden and systemic inflammatory status. Hepato-biliary function should be monitored carefully during i.v. treatment, possibly important in CF patients with pre-existing liver disease.
RCT Entities:
BACKGROUND:Cystic fibrosis (CF) is characterized by chronic bacterial broncho-pulmonary infection. Although intravenous (i.v.) antibiotic therapy is regarded as standard treatment in CF, only few randomised trials comparing different antibiotic compounds exist. METHODS: We report on a prospective multicenter interventional trial of i.v. meropenem (120 mg/kg/day) or i.v. ceftazidime (200-400 mg/kg/day), each administered together with i.v. tobramycin (9-12 mg/kg/day). Outcome measures were changes in lung function, microbiological sputum burden and blood inflammatory marker. Liver and renal function values were measured to assess safety. RESULTS: One hundred eighteen patients (59/59) were included into the study with the following indications: first infection of P. aeruginosa (n=6), acute pulmonary exacerbation (n=34) and suppression therapy of chronic P. aeruginosa colonization (n=78). Both treatments improved lung function measures, bacterial sputum burden and CRP levels with no differences between treatment groups observed. A significant higher elevation for alkaline phosphatase (p<0.0001) was observed for patients in the meropenem/tobramycin group. CONCLUSIONS: i.v. antibiotic therapy in CFpatients with meropenem/tobramycin is as effective as with ceftazidime/tobramycin regarding lung function, microbiological sputum burden and systemic inflammatory status. Hepato-biliary function should be monitored carefully during i.v. treatment, possibly important in CFpatients with pre-existing liver disease.
Authors: P Bourget; A Amin; C Dupont; M Abely; N Desmazes-Dufeu; J C Dubus; B-L Jouani; C Merlette; R Nové-Josserand; J Pages; R Panzo; F Vidal; F Voge; D Hubert Journal: Antimicrob Agents Chemother Date: 2014-03-10 Impact factor: 5.191
Authors: Andrea Hahn; Caroline Jensen; Hani Fanous; Hollis Chaney; Iman Sami; Geovanny F Perez; Stan Louie; Anastassios C Koumbourlis; James E Bost; John N van den Anker Journal: J Pediatr Pharmacol Ther Date: 2018 Sep-Oct
Authors: Jeffrey S Wagener; Lawrence Rasouliyan; Donald R VanDevanter; David J Pasta; Warren E Regelmann; Wayne J Morgan; Michael W Konstan Journal: Pediatr Pulmonol Date: 2012-08-08
Authors: Jenna B Allard; Lisa Rinaldi; Matthew J Wargo; Gilman Allen; Shizuo Akira; Satoshi Uematsu; Matthew E Poynter; Deborah A Hogan; Mercedes Rincon; Laurie A Whittaker Journal: Eur J Immunol Date: 2009-03 Impact factor: 5.532