Abstract
The clinical efficacy of the conventional aminoglycoside plus beta-lactam treatment was compared to that of monotherapy with oral quinolones in 26 adult cystic fibrosis patients in an open prospective clinical trial in which six two-week courses of antipseudomonas treatment were administered with an interval of approximately three months between treatments. In each patient two courses of conventional treatment were followed by two courses of quinolone treatment and then by another two courses of conventional treatment. The observed improvements in pulmonary function were somewhat higher when the patients received conventional treatments, and in the most seriously affected patients conventional treatment was significantly better than quinolone treatment. On the basis of these findings it is suggested that quinolone monotherapy cannot replace conventional antipseudomonal chemotherapy in patients with severe pulmonary involvement.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Pedersen, S. S., Jensen, T., Pressler, T., Rosendal, K.: Does centralized treatment of cystic fibrosis increase the risk ofPseudomonas aeruginosa infection? Acta Paediatrica Scandinavia 1986, 75: 840–845.
Høiby, N., Flensborg, E. W., Beck, B., Friis, B., Vidar-Jacobsen, S., Jacobsen, L.:Pseudomonas aeruginosa infection in cystic fibrosis. Diagnostic and prognostic significance ofPseudomonas aeruginosa precipitins determined by means of crossed immunoelectrophoresis. Scandinavian Journal of Respiratory Diseases 1977, 58: 65–79.
Høiby, N., Friis, B., Jensen, K., Koch, C., Møller, N. E., Støvring, S., Szaff, M.: Antimicrobial chemotherapy in cystic fibrosis patients. Acta Paediatrica Scandinavica 1982, 301, Supplement: 75–100.
Cherny, F. J., Cropp, G. J. A., Bye, M. R.: Hospital therapy improves exercise tolerance and lung function in cystic fibrosis. American Journal of Diseases of Children 1984, 133: 261–265.
Szaff, M., Høiby, N., Flensborg, E. W.: Frequent antibiotic therapy improves survival of cystic fibrosis patients with chronicPseudomonas aeruginosa infection. Acta Paediatrica Scandinavica 1983, 72: 651–657.
Sato, K., Matsuura, Y., Inoue, M., Une, T., Osada, Y., Ogawa, H., Mitsuhashi, S.: In vitro and in vivo activity of DL-8280, a new oxacine derivative. Antimicrobial Agents and Chemotherapy 1982, 22: 548–553.
Wise, R., Andrews, J. M., Edwards, L. J.: In vitro activity of Bayer 09867. A new quinolone derivative compared with those of other antimicrobial agents. Antimicrobial Agents and Chemotherapy 1983, 23: 559–564.
LeBel, M., Bergeron, M. G., Vallèe, F., Fiset, C., Chasse, G., Bigonesse, P., Rivard, G.: Pharmacokinetics and pharmacodynamics of ciprofloxacin in cystic fibrosis patients. Antimicrobial Agents and Chemotherapy 1986, 30: 260–266.
Scully, B. J., Neu, H. C., Parry, M. F., Mandell, W.: Oral ciprofloxacin therapy of infections due toPseudomonas aeruginosa. Lancet 1986, i: 819–822.
Smith, M. J., Hodson, M. E., Batten, J. C.: Ciprofloxacin in cystic fibrosis. Lancet 1986, i: 1103.
Hodson, M. E., Roberts, C. M., Butland, R. J. A., Smith, M. J.: Oral ciprofloxacin compared with conventional intravenous treatment forPseudomonas aeruginosa infection in adults with cystic fibrosis. Lancet 1987, i: 235–237.
Quanjer, Ph. H., Dalhuijsen, A., van Zomeren, B. C.: Summary equations of reference values. Bulletin Europeen Physiopathologie Respiratoire 1983, 19, Supplement 5: 45–51.
Rahe, A. J.: Tables of critical values for the Pratt matched pair signed rank statistic. Journal of American Statistical Association 1974, 69: 368–373.
Szaff, M., Høiby, N.: Antibiotic treatment ofStaphylococcus aureus infection in cystic fibrosis. Acta Paediatrica Scandinavica 1982, 71: 821–826.
Pressler, T., Szaff, M., Høiby, N.: Antibiotic treatment ofHaemophilus influenzae andHaemophilus parainfluenzae in patients with cystic fibrosis. Acta Paediatrica Scandinavica 1984, 73: 541–547.
Penketh, A. R. L., Hodson, M. E., Gaya, H., Batten, J. C.: Azlocillin compared with carbenicillin in the treatment of bronchopulmonary infection due toPseudomonas aeruginosa in cystic fibrosis. Thorax 1984, 39: 299–304.
Chalkley, L. J., Koornhof, H. J.: Antimicrobial activity of ciprofloxacin againstPseudomonas aeruginosa, Escherichia coli andStaphylococcus aureus determined by the killing curve method: Antibiotic comparisons and synergistic interactions. Antimicrobial Agents and Chemotherapy 1985, 28: 331–342.
Chapman, S. T., Speller, D. C. E., Reeves, D. S.: Resistance to ciprofloxacin. Lancet 1985, ii: 39.
Roberts, C. M., Batten, J. C., Hodson, M. E.: Ciprofloxacin resistantPseudomonas. Lancet 1985, i: 1442.
Davies, B. I., Maesen, F. P. V., Baur, C.: Ciprofloxacin in the treatment of chronic bronchitis. European Journal of Clinical Microbiology 1986, 5: 226–231.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jensen, T., Pedersen, S.S., HøSiby, N. et al. Efficacy of oral fluoroquinolones versus conventional intravenous antipseudomonal chemotherapy in treatment of cystic fibrosis. Eur. J, Clin. Microbiol. 6, 618–622 (1987). https://doi.org/10.1007/BF02013055
Issue Date:
DOI: https://doi.org/10.1007/BF02013055