Study design (if review, criteria of inclusion for studies)
randomized, double-blind trial
Participants
111 cystic fibrosis patients with predominant and susceptible pseudomonas in their sputum.
Interventions
azlocillin, piperacillin, ceftazidime, cefsulodin or cefoperazone
Outcome measures
Results were evaluated by a clinical, radiological and bacteriological scoring system
Main results
the best results were obtained with ceftazidime, followed by cefsulodin and piperacillin. However, pseudomonas was eradicated in only 22 (23%) of the cases with the most active drugs and persisted or reappeared in all the cases 1 to 3 months later. Ceftazidime always eradicated Staph. aureus and Haemophilus influenzae associated with pseudomonas. Similar eradication occurred nearly always with cefsulodin but rarely with the other drugs. No serious drug reaction occurred but a later fever and rash with piperacillin, transient diarrhoea with cefoperazone, vomiting with cefsulodin, and very frequent eosinophilia with ceftazidime should be mentioned.
Authors' conclusions
These five drugs offer, in varying degree, alternatives to traditional anti pseudomonas antibiotics in cystic fibrosis pulmonary infections, but they should be used only against well-proven resistant strains. Ceftazidime is best and cefotaxime and latamoxef (moxalactam) least useful.