Treatment of pulmonary infections in patients with cystic fibrosis: A comparative study of ticarcillin and gentamicin

Parry, Michael F.; Neu, Harold C.; Merlino, Mario; Gaerlan, Pureza F.; Ores, Celia N.; Denning, Carolyn R.

doi:10.1016/s0022-3476(77)80790-7

Cited by 66 publications

(20 citation statements)

References 13 publications

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“…Previous studies have reported the emergence of other multiresistant microorganisms as respiratory tract colonizers in CF patients under comparable conditions. 24,25 Number of days of oral corticosteroid therapy was found to be an independent predictor of S. maltophilia isolation in our population of CF patients in a stepwise logistic regression that excluded spirometric variables. Although this analysis does not fully take into consideration the patients' clinical status, it suggests that other medications, besides antibiotics, may also have a role in the increasing emergence of S. maltophilia among CF patients.…”

Section: Discussionmentioning

confidence: 81%

Risk factors for emergence ofStenotrophomonas maltophilia in cystic fibrosis

et al. 2000

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Section: Discussionmentioning

confidence: 81%

Risk factors for emergence ofStenotrophomonas maltophilia in cystic fibrosis

et al. 2000

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“…Adequate allocation concealment was reported in 23/52 trials (44%). In five trials alternation or other methods suspected to result in non-truly random patient assignment were used [94,101,103,121,122]. Only five trials were double-blinded [75,109,117,120,123].…”

Section: Resultsmentioning

confidence: 99%

“…Two trials performed screening audiograms and in these 1/69 patients developed ototoxicity compared with 0/71 with monotherapy [111,123]. Four trials reported that no cases of ototoxicity were observed without dedicated screening [104,108,116,122]. Five trials reported development of pseudomembranous colitis with few or no events.…”

Section: Secondary Outcomesmentioning

confidence: 99%

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

Marcus

Paul

Elphick

et al. 2011

International Journal of Antimicrobial Agents

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“…Tpe combination of ticarcillin or carbenicillin with aminoglycosides is synergistic in vitro against P. aeruginosa (Wald et al 1975). Ticarcillin has been extensively used in the treatment of infectious exacerbations of cystic fibrosis pulmonary disease with P. aeruginosa (McLaughlin et al 1983;Parry & Neu 1976b;Parry et al 1977).…”

Section: Ticarcillinmentioning

confidence: 99%

Antibiotic Pharmacokinetics in Cystic Fibrosis

1987

Clinical Pharmacokinetics

148

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Antibiotics are administered to cystic fibrosis patients for chronic endobronchial infection complicated by frequent exacerbations. Agents active against Staphylococcus aureus, Pseudomonas aeruginosa or both are administered. Serum antibiotic concentrations were measured in cystic fibrosis patients in an effort to optimise antibiotic dose and frequency. This led to the observation that cystic fibrosis subjects had (in general) a larger Vd and increased total body clearance of beta-lactams and aminoglycosides than non-cystic fibrosis subjects. The larger Vd is mainly due to the increased amount of lean body mass per kg bodyweight, although increased tissue binding may also account for part of this. The increased total body clearance of beta-lactams appears to be due to increased renal elimination, particularly tubular secretion. Decreased tubular reabsorption and increased non-renal clearance contribute to the increased total body clearance of metabolised beta-lactams and aminoglycosides. However, the lack of concomitant controls in many studies make these generalisations tentative. The result of the apparent cystic fibrosis-specific differences is lower peak serum antibiotic concentrations, a smaller AUC, and a shorter elimination half-life than non-cystic fibrosis subjects. Since sputum (and bronchial mucosal) concentration is dependent on the peak serum concentration (and AUC), cystic fibrosis subjects require larger doses of most antibiotics more frequently. Newer quinolones may be an exception. Studies comparing the efficacy and safety of larger and more frequent antibiotic doses to conventional therapy are not available. Although it appears logical to mimic serum antibiotic concentrations found in non-cystic fibrosis subjects, the lack of information on the ideal sputum concentration versus time curve should temper our enthusiasm for cystic fibrosis-specific dosage regimens.

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Treatment of pulmonary infections in patients with cystic fibrosis: A comparative study of ticarcillin and gentamicin

Cited by 66 publications

References 13 publications

Risk factors for emergence ofStenotrophomonas maltophilia in cystic fibrosis

Risk factors for emergence ofStenotrophomonas maltophilia in cystic fibrosis

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

Antibiotic Pharmacokinetics in Cystic Fibrosis

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