Cystic Fibrosis, Pseudomonas Aeruginosa, Pulmonary Exacerbation
Conditions
Keywords
Ceftazidime, Continuous infusion, Antibiotic course
Brief summary
The aim of this trial was to compare the safety and efficacy of courses of tobramycin and ceftazidime, administered intravenously as either thrice daily short infusions or 24 h continuous infusion, in cystic fibrosis patients with acute exacerbation of chronic pulmonary PA infection. In conventional treatment regimens, ceftazidime is administered in the form of thrice daily short infusions, but pharmacodynamic considerations suggest that continuous infusion could be more effective.
Detailed description
Each patient received two successive IV antibiotic courses during a period of pulmonary exacerbation. One of these courses was delivered as thrice daily 30-minute infusions of ceftazidime in 100 ml of 0.9% sodium chloride, and the other was delivered as a continuous infusion of ceftazidime in 230 ml of 0.9% sodium chloride, over 23 hours. The daily dose of ceftazidime was 200 mg/kg, with a maximum dose of 12 g. For ceftazidime continuous infusion, a loading dose of 60 mg/kg (maximum 2 g) was used. All patients also received tobramycin (10 mg/kg), in the form of one 30-minute infusion per day. Portable devices were used: Intermate® SV 200 (Baxter) for the 30-minute short infusions of ceftazidime and tobramycin, Infusor® LV10 (Baxter) for continuous infusion of ceftazidime.
Interventions
DRUGceftazidime
Sponsors
Vaincre la Mucoviscidose
GlaxoSmithKline
Baxter Healthcare Corporation
Roche Pharma AG
Association Nationale pour les Traitements A Domicile, les Innovations et la Recherche
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
8 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients with cystic fibrosis older than 8 years * with chronic Pseudomonas aeruginosa infection of the respiratory tract * with at least 2 courses of IV antibiotic in the year before enrolment * at the time of a pulmonary exacerbation
Exclusion criteria
* allergy to ceftazidime or tobramycin * bronchial colonization with Burkholderia cepacia * renal impairment * history of lung transplantation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in forced expiratory volume in 1s (FEV1) between the beginning and the end of the IV antibiotic course, expressed as a percentage of the predicted normal value | — |
Secondary
| Measure | Time frame |
|---|---|
| the interval between 2 successive IV antibiotic courses | — |
| quality of life scores | — |
| sputum collected at the beginning and the end of each antibiotic course | — |
| plasma ceftazidime concentration at steady state (Css) for ceftazidime continuous infusion, and before (C trough), 30 minutes (Cmax) and 4 hours after (C4) the beginning of ceftazidime short infusion | — |
| C-reactive protein, leukocytes and hepatic enzymes levels at the beginning and the end of each IV antibiotic course | — |
Countries
France
Outcome results
None listed