Ciprofloxacin as antipseudomonal treatment in patients with cystic fibrosis.
OBJECTIVE
The efficacy and safety of oral ciprofloxacin as a maintenance antipseudomonal therapy were evaluated in 44 patients with cystic fibrosis who had completed a 14-day regimen of intensive hospital therapy with intravenous ceftazidime and amikacin, supplemented by amikacin inhalation therapy.


METHODS
Twenty-one patients were randomly assigned to oral ciprofloxacin alone (Group I) and 23 received ciprofloxacin plus inhaled amikacin (Group II).


RESULTS
Negative sputum cultures were achieved in 34 patients (77%) at the end of intensive therapy (19 Group I and 15 Group II) and were sustained after 3 months of maintenance therapy in 5 of the 19 responders in Group I (26%) and in 8 of the 15 responders in Group II (53%). Resistance to ciprofloxacin was found in 7 of 31 (23%) sputum isolates at the end of ciprofloxacin therapy. During maintenance therapy, continued improvement in clinical symptoms was observed in 14 patients in both treatment groups; 6 in each group had further improvements whereas only 4 patients were clinical failures. There was no correlation between clinical outcome and either elimination of Pseudomonas aeruginosa from sputum culture or development of ciprofloxacin resistance. Both maintenance regimens were well-tolerated by this population of patients which included 28 children younger than 15 years of age. There were no severe or serious adverse events, no signs of quinolone-related arthropathy and no growth impairment.


CONCLUSIONS
Ciprofloxacin was efficacious, safe and well-tolerated as maintenance antipseudomonal therapy in cystic fibrosis patients. These results suggest further evaluation of ciprofloxacin as an oral maintenance therapy is warranted.
Schaad
U B
UB
Division of Pediatric Infectious Diseases, University of Berne, Switzerland.
Wedgwood
J
J
Ruedeberg
A
A
Kraemer
R
R
Hampel
B
B
D000293:Adolescent; D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002442:Ceftazidime / Q000627:therapeutic use; D002648:Child; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D000583:Amikacin; D002442:Ceftazidime