Evaluation of once daily tobramycin versus the traditional three time daily for the treatment of acute pulmonary exacerbations in adult cystic fibrosis patients.
Study design (if review, criteria of inclusion for studies)
prospective, randomized study
Participants
15 adult cystic fibrosis patients colonized with Pseudomonas aeruginosa
Interventions
OD with TDS tobramycin, each plus a second anti-pseudomonal, for the treatment of acute infective exacerbation. the same individuals received the alternate treatment regime for the next exacerbation
Outcome measures
clinical and bacteriological, efficacy, toxicity, and the effects on susceptibility of the organism among patients in both treatment groups. Isolates were identified, and the Minimum Inhibitory Concentration (MIC) of the antibiotic in each patient was performed. Patients were assessed for clinical improvement, toxicity and the total viable count in their sputum on days 0, 7 and 14.
Main results
In both treatment groups there was a significant clinical improvement, and toxicity did not occur in either group. There was no difference in clinical outcome, adverse events, or time to the next exacerbation. No difference was seen in the selection of antibiotic resistance. OD tobramycin appeared more effective in reducing the number of bacteria in the group overall at day 7 and in two individuals, at day 14.