Related Experiment Videos
Azlocillin in cystic fibrosis
Insights
This study evaluated azlocillin with gentamicin or tobramycin for cystic fibrosis patients with Pseudomonas aeruginosa lung infections. While azlocillin reached therapeutic levels, it rarely eradicated Pseudomonas aeruginosa from sputum.
Area of Science:
- Medical Microbiology
- Pharmacology
- Pulmonology
Background:
- Lower respiratory tract infections (LRTIs) due to Pseudomonas aeruginosa are common in cystic fibrosis (CF) patients.
- Effective antibiotic strategies are crucial for managing chronic P. aeruginosa colonization in CF.
Purpose of the Study:
- To evaluate the efficacy of combined azlocillin and either gentamicin or tobramycin for treating LRTIs caused by P. aeruginosa in CF patients.
- To assess the pharmacokinetic properties and sputum penetration of azlocillin in this patient population.
Main Methods:
- A prospective study involving 20 CF patients (mean age 13.5 years) with P. aeruginosa LRTIs.
- Patients received intravenous azlocillin combined with either gentamicin or tobramycin for 10-12 days.
- Concurrent treatments included inhalation therapy, physiotherapy, and pancreatic enzymes.
Main Results:
- Serum azlocillin concentrations were within therapeutic ranges.
- Azlocillin inhibited 75% of P. aeruginosa strains in sputum samples.
- Complete eradication of P. aeruginosa from sputum was achieved in only 12 out of 52 treatment courses.
Conclusions:
- Combination therapy with azlocillin and aminoglycosides showed limited success in eradicating P. aeruginosa from CF patient sputum.
- Further research is needed to optimize antibiotic regimens for chronic P. aeruginosa infections in cystic fibrosis.
Abstract:
The combination of azlocillin and gentamicin or tobramycin, in the treatment of lower respiratory tract infection due to Pseudomonas aeruginosa in patients with cystic fibrosis, was evaluated. Twenty patients, 10 boys and 10 girls (mean age 13 1/2 years) who had lower respiratory tract infection with positive sputum culture for P. aeruginosa, were given azlocillin i.v. 20 mg/kg every 8 hours for 10 to 12 days. In addition, either gentamicin, 2.5 to 4 mg/kg i.v. every 12 hours, or tobramycin, 4 to 5 mg/kg i.v. every 8 hours, was given. The antibiotics were given in short-term infusions (20 minutes). Besides the antibiotic treatment, the patients received inhalation therapy, pulmonary physiotherapy, and pancreatic enzymes. Pharmacokinetic studies showed that azlocillin concentrations in serum were within therapeutic levels, and in sputum they inhibited 75% of all P. aeruginosa strains. However, in only 12 of the 52 treatment courses was Pseudomonas eliminated from the sputum.