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.
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.
Richard
D A
DA
Department of Paediatrics, University of Witwatersrand Medical School, Parktown, South Africa.
Nousia-Arvanitakis
S
S
Sollich
V
V
Hampel
B J
BJ
Sommerauer
B
B
Schaad
U B
UB
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
D002939:Ciprofloxacin; D002442:Ceftazidime; D014031:Tobramycin