Evaluation of Efficacy and Safety of Fixed Dose Combination of Ceftazidime-Tobramycin in Comparison with Ceftazidime in Lower Respiratory Tract Infections

Abstract

Lower respiratory tract infections are major cause of morbidity and mortality. Objectives were to evaluate efficacy and safety of fixed dose combination (FDC) of Ceftazidime and Tobramycin in comparison with Ceftazidime alone in patients with lower respiratory tract infections. Patients (n=240) were randomly distributed in two arms: one arm was treated with Ceftazidime(1g)-Tobramycin(120mg) and other arm was treated with Ceftazidime (1g) alone. Patients were clinically, radiologically and bacteriologically evaluated. Clinically successful outcome was seen in 88.4% of the patients in Ceftazidime-Tobramycin treated group as compared to 61.2% in Ceftazidime alone treated group. In Ceftazidime-Tobramycin treated group, majority of pathogen isolated were H.inflenzae (35%), P. aeruginosa (24.16%), K. pneumoniae (16.66%) and M. catarrhalis (24.16%), whereas in Ceftazidime alone treated group majority of pathogen isolated were H.inflenzae (33.33%), P. aeruginosa (20%), K. pneumoniae (18.33%) and M. catarrhalis (28.33%). In Ceftazidime-Tobramycin treated group (98%), a significantly higher bacterial eradication was observed than Ceftazidime alone treated group (79%). Radiological improvement was also superior in Ceftazidime-Tobramycin treated group. No major adverse events were observed. Results showed that fixed dose combination of Ceftazidime Tobramycin is superior than Ceftazidime alone in the treatment of lower respiratory tract infections.

Clinical implications of β-lactam–aminoglycoside synergism: systematic review of randomised trials

“…1). The trials were divided into six major clinical categories based on the type of infection addressed (Table 1): febrile neutropenia (21 trials [72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90]); pneumonia, including one trial with lower respiratory tract infection (8 trials [91][92][93][94][95][96][97][98]); abdominal or urinary tract infection (4 trials [99][100][101][102]); severe sepsis or bacteraemia (10 trials [73,[103][104][105][106][107][108][109][110][111]); endocarditis (4 trials [112][113][114][115]); and CF or bronchitis (8 trials [116][117]…”

A systematic review of acute and emergency care interventions for adolescents and adults with severe acute respiratory infections including COVID-19 in low- and middle-income countries

“…Four of the eight RCTs evaluating antibiotics found no difference in clinical efficacy when comparing the following antibiotic regimens: gatifloxacin vs ceftriaxone (92% and 88% cure rate; P -value not reported), biapenem vs meropenem (94.7% vs 93.75% clinical efficacy; P -value not reported), levofloxacin five day vs seven day course (cure rate 56% vs 56.8%; difference = -0.8; 95% CI = -13.9 to 12.3) and levofloxacin vs ceftriaxone with azithromycin (hospital LOS 3.3 vs 3.4; P = 0.15) [ 59 , 61 , 63 , 64 ]. Abengowe et al [ 57 ] found higher cure rates (68.2% vs 36.5%; P < 0.01) with TMP-SMX over tetracycline in Nigeria, and Chaudhary et al [ 58 ] found benefit for ceftazidime-tobramycin over ceftriaxone in India (88.4% vs 61.2%; P -value not reported), although with high risk of bias. Tieying et al [ 62 ] found that clinical cure at seven days was greater for moxifloxacin over levofloxacin/metronidazole (76.7% vs 51.7%; P = 0.045) among patients with CAP with aspiration risk factors at seven days, although no difference at the end of the treatment period at 14 days (83.3% vs 71.8%; P = 0.233).…”

Effect of Tobracef on biofilms of aminoglycoside resistant Pseudomonas aeruginosa

“…Tobracef, is one such novel drug (under patent protection) which is a combination of third-generation beta lactam antibiotic ceftazidime and tobramycin in a ratio of 8.33:1, supplied with solvent. Tobracef has been demonstrated to have noticeable antibacterial activity [24]. Its antibacterial activity has also been proved in animal model [25].…”