title: Oral ciprofloxacin vs. intravenous ceftazidime plus tobramycin in pediatric cystic fibrosis patients: comparison of antipseudomonas efficacy and assessment of safety with ultrasonography and magnetic resonance imaging. Cystic Fibrosis Study Group.
abstract: BACKGROUND
  More data on the efficacy and safety of ciprofloxacin in pediatric cystic fibrosis patients are needed.
  
  
  METHODS
  One hundred eight pediatric cystic fibrosis patients (ages 5 to 17 years) with acute bronchopulmonary exacerbations entered a randomized multicenter trial designed to compare the safety and efficacy of antipseudomonas therapy with oral ciprofloxacin (15 mg/kg twice daily; maximum dosage 750 mg twice daily) or intravenous ceftazidime plus tobramycin (CAZ/TM) for 14 days.
  
  
  RESULTS
  Clinical improvement was observed in 93% of patients treated with oral ciprofloxacin and in 96% of those receiving parenteral therapy. Transient suppression of Pseudomonas aeruginosa was achieved in 63% of patients at the end of the course of iv CAZ/TM therapy and in 24% receiving ciprofloxacin. Ultrasound examination and nuclear magnetic resonance imaging scans showed no evidence of cartilage toxicity in any of the ciprofloxacin-treated patients. Musculoskeletal adverse events were reported with similar frequency in the two groups of patients (7% in the group receiving ciprofloxacin therapy and 11% in the IV CAZ/TM group). The only sustained musculoskeletal symptom was a case of synovitis in a patient receiving parenteral CAZ/TM.
  
  
  CONCLUSIONS
  Ciprofloxacin thus appears to be safe and effective for use in young patients with bronchopulmonary exacerbation of cystic fibrosis.
authors.affiliation: Department of Paediatrics, University of Witwatersrand Medical School, Parktown, South Africa.
authors.forename: D A
authors.initials: DA
authors.lastname: Richard
authors.forename: S
authors.initials: S
authors.lastname: Nousia-Arvanitakis
authors.forename: V
authors.initials: V
authors.lastname: Sollich
authors.forename: B J
authors.initials: BJ
authors.lastname: Hampel
authors.forename: B
authors.initials: B
authors.lastname: Sommerauer
authors.forename: U B
authors.initials: UB
authors.lastname: Schaad
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002356:Cartilage / Q000187:drug effects; D002442:Ceftazidime / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D014031:Tobramycin / Q000009:adverse effects / Q000627:therapeutic use*; D014463:Ultrasonography
chemical_list: D002939:Ciprofloxacin; D002442:Ceftazidime; D014031:Tobramycin