Antibacterial Therapy for Exacerbations of Cystic Fibrosis Tobramycin + carbenicillin Is effective against P. aeruglnosa-induced exacerbations In an open study. 10 patients with cystic fibrosis (mean age 16.6 years) received a total of 14 courses of IV tobramycin titrated to 10.0-17.1 mg/kg/day (given in 4 divided doses) plus IV carbenicillin 100 mg/kg 6 times daily for 11-24 days. All patients were suffering from an acute exacerbation of Pseudomonas aeruginosa. A bacteriological cure was achieved in 9/13 courses (69.2%) while 13/14 courses (92.8%) improved clinically (weight gain and a reduction in production of sputum. dyspnoea and the degree of cyanosis). By the end of treatment. FEV 1 and FVC had improved significantly (39.3 and 24.1%. respectively) and the leucocyte and neutrophil counts had decreased significantly (from 11 and 8.5. respectively. to 6.3 and 3.4. respectively). Side effects attributed to tobramycin included elevated serum creatinine (1 patient) cylindruria (2) and a mild unilateral loss of hearing (1) . Elevated levels of 'Y-glutamyl transferase (29% of cases) were attributed to carbenicillin . The study concluded that combination tobramycin + carbenicillin therapy acheived a' ... bacteriologic cure with a minimal degree of toxicity' and ' .•• the utility of using a one-compartment, first-order pharrnacokinetic model for tobramycin dosing in CF patients' (Sawchuck-Zaske method) was demonstrated. Fraser, G.L. ; Valenti, A.J .; Grimes, G.R. and Corbin, R.P. Drug Intelligence and Clinical Pharmacy 19: 757·761 (Oct 1985) 0156-2703/ 85/ 1005-0013/ 0$01.00/0 @ ADIS Press INPHARMA ® 23 Nov 1985 13

Antibacterial Therapy for Exacerbations of Cystic Fibrosis

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Page 1: Antibacterial Therapy for Exacerbations of Cystic Fibrosis

Antibacterial Therapy for Exacerbations of Cystic Fibrosis Tobramycin + carbenicillin Is effective against P. aeruglnosa-induced exacerbations

In an open study. 10 patients with cystic fibrosis (mean age 16.6 years) received a total of 14 courses of IV tobramycin titrated to 10.0-17.1 mg/kg/day (given in 4 divided doses) plus IV carbenicillin 100 mg/kg 6 times daily for 11-24 days. All patients were suffering from an acute exacerbation of Pseudomonas aeruginosa.

A bacteriological cure was achieved in 9/13 courses (69.2%) while 13/14 courses (92.8%) improved clinically (weight gain and a reduction in production of sputum. dyspnoea and the degree of cyanosis). By the end of treatment. FEV1 and FVC had improved significantly (39.3 and 24.1%. respectively) and the leucocyte and neutrophil counts had decreased significantly (from 11 and 8.5. respectively. to 6.3 and 3.4. respectively). Side effects attributed to tobramycin included elevated serum creatinine (1 patient) cylindruria (2) and a mild unilateral loss of hearing (1) . Elevated levels of 'Y-glutamyl transferase (29% of cases) were attributed to carbenicillin.

The study concluded that combination tobramycin + carbenicillin therapy acheived a' ... bacteriologic cure with a minimal degree of toxicity' and ' .•• the utility of using a one-compartment, first-order pharrnacokinetic model for tobramycin dosing in CF patients' (Sawchuck-Zaske method) was demonstrated. Fraser, G.L. ; Valenti, A.J.; Grimes, G.R. and Corbin, R.P. Drug Intelligence and Clinical Pharmacy 19: 757·761 (Oct 1985)

0156-2703/ 85/ 1005-0013/ 0$01 .00/0 @ ADIS Press INPHARMA® 23 Nov 1985 13