Clinical and bacteriological responses to three antibiotic regimens for acute exacerbations of cystic fibrosis: ticarcillin-tobramycin, azlocillin-tobramycin, and azlocillin-placebo

J Infect Dis. 1983 Mar;147(3):559-67. doi: 10.1093/infdis/147.3.559.

Abstract

In a randomized, double-blind study, cystic fibrosis patients 11-30 years of age with an acute exacerbation of their pulmonary disease were treated with either ticarcillin-tobramycin, azlocillin-tobramycin, or azlocillin-placebo for 10 days. There was significant improvement in Shwachman scores and pulmonary function tests. Concentrations of sputum bacteria were significantly reduced, but after therapy patients had a mean of 10(7) bacteria/ml of sputum. Pseudomonas was transiently eliminated in only one patient. The three regimens had similar impacts on pulmonary function and sputum bacterial concentration. Antibiotic resistance was noted more frequently in the azlocillin-placebo group, but this trend was not statistically significant. Improvement in pulmonary function did not correlate with bacteriological response. Four weeks after discharge, 62% of the improvement in forced expiratory volume in one second and 75% of the improvement in vital capacity remained, but concentrations of sputum bacteria had returned to pretreatment levels, and antibiotic-resistant bacteria persisted.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Azlocillin
  • Child
  • Clinical Trials as Topic
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / physiopathology
  • Double-Blind Method
  • Drug Therapy, Combination
  • Humans
  • Lung / physiopathology
  • Penicillin Resistance
  • Penicillins / administration & dosage*
  • Penicillins / therapeutic use
  • Random Allocation
  • Ticarcillin / administration & dosage*
  • Ticarcillin / therapeutic use
  • Tobramycin / administration & dosage*
  • Tobramycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Penicillins
  • Ticarcillin
  • Azlocillin
  • Tobramycin