Oral ciprofloxacin vs. intravenous ceftazidime plus tobramycin in pediatric cystic fibrosis patients: comparison of antipseudomonas efficacy and assessment of safety with ultrasonography and magnetic resonance imaging. Cystic Fibrosis Study Group.

Abstract

BACKGROUND:

More data on the efficacy and safety of ciprofloxacin in pediatric cystic fibrosis patients are needed.

METHODS:

One hundred eight pediatric cystic fibrosis patients (ages 5 to 17 years) with acute bronchopulmonary exacerbations entered a randomized multicenter trial designed to compare the safety and efficacy of antipseudomonas therapy with oral ciprofloxacin (15 mg/kg twice daily; maximum dosage 750 mg twice daily) or intravenous ceftazidime plus tobramycin (CAZ/TM) for 14 days.

RESULTS:

Clinical improvement was observed in 93% of patients treated with oral ciprofloxacin and in 96% of those receiving parenteral therapy. Transient suppression of Pseudomonas aeruginosa was achieved in 63% of patients at the end of the course of iv CAZ/TM therapy and in 24% receiving ciprofloxacin. Ultrasound examination and nuclear magnetic resonance imaging scans showed no evidence of cartilage toxicity in any of the ciprofloxacin-treated patients. Musculoskeletal adverse events were reported with similar frequency in the two groups of patients (7% in the group receiving ciprofloxacin therapy and 11% in the IV CAZ/TM group). The only sustained musculoskeletal symptom was a case of synovitis in a patient receiving parenteral CAZ/TM.

CONCLUSION:

Ciprofloxacin thus appears to be safe and effective for use in young patients with bronchopulmonary exacerbation of cystic fibrosis.

• Authors: D A Richard, S Nousia-Arvanitakis, V Sollich, B J Hampel, B Sommerauer, U B Schaad
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 16 Issue 6 Pg. 572-8 (Jun 1997) ISSN: 0891-3668 [Print] United States
• PMID: 9194107 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Ciprofloxacin
• Ceftazidime
• Tobramycin

Topics

• Administration, Oral
• Adolescent
• Cartilage (drug effects)
• Ceftazidime (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Ciprofloxacin (adverse effects, therapeutic use)
• Cystic Fibrosis (diagnostic imaging, drug therapy)
• Drug Therapy, Combination (therapeutic use)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Pseudomonas Infections (drug therapy)
• Pseudomonas aeruginosa (drug effects)
• Tobramycin (adverse effects, therapeutic use)
• Ultrasonography