Comparison of piperacillin vs. ticarcillin plus tobramycin in the treatment of acute pulmonary exacerbations of cystic fibrosis

M. A. Jackson, H. Kusmiesz, S. Shelton, C. Prestidge, R. I. Kramer, J. D. Nelson

Research output: Contribution to journalArticle

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Abstract

During a 22-month period 35 children with cystic fibrosis received 52 courses of antibiotic therapy for acute pulmonary exacerbations, including 26 cases of therapy with piperacillin and 26 courses with ticarcillin plus tobramycin. Groups were similar in age (5 vs. 5.4 years), disease severity based on Schwachman scores and presenting symptoms. Pseudomonas aeruginosa was the most common organism isolated in 90% of sputum cultures. Mean minimal inhibitory concentrations for piperacillin, ticarcillin and tobramycin were 8, 64 and 1 μg/ml, respectively. Piperacillin pharmacokinetic data revealed an average half-life in serum of 36 minutes. Peak serum concentrations averaged 144 μg/ml, and after 4 hours serum concentrations continued to exceed the P. aeruginosa 90% minimal inhibitory concentration in 50% of children. The dosage requirement for tobramycin was quite variable, necessitated monitoring of aminoglycoside serum concentration ands in most cases resulted in at least one dosage adjustment. Emergence of resistant bacteria was not seen in 26 courses of piperacillin therapy. Both regimens were effective and well-tolerated. Single agent therapy has the advantage of providing reliable serum concentrations and, in contrast the standard therapy, does not necessitate monitoring of serum drug concentrations.

Original languageEnglish (US)
Pages (from-to)440-443
Number of pages4
JournalPediatric Infectious Disease
Volume5
Issue number4
StatePublished - 1986

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Ticarcillin
Piperacillin
Tobramycin
Cystic Fibrosis
Serum
Pseudomonas aeruginosa
Therapeutics
Drug Monitoring
Aminoglycosides
Sputum
Inhibitory Concentration 50
Half-Life
Pharmacokinetics
Anti-Bacterial Agents
Bacteria
Lung

ASJC Scopus subject areas

  • Medicine(all)

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Comparison of piperacillin vs. ticarcillin plus tobramycin in the treatment of acute pulmonary exacerbations of cystic fibrosis. / Jackson, M. A.; Kusmiesz, H.; Shelton, S.; Prestidge, C.; Kramer, R. I.; Nelson, J. D.

In: Pediatric Infectious Disease, Vol. 5, No. 4, 1986, p. 440-443.

Research output: Contribution to journalArticle

Jackson, M. A. ; Kusmiesz, H. ; Shelton, S. ; Prestidge, C. ; Kramer, R. I. ; Nelson, J. D. / Comparison of piperacillin vs. ticarcillin plus tobramycin in the treatment of acute pulmonary exacerbations of cystic fibrosis. In: Pediatric Infectious Disease. 1986 ; Vol. 5, No. 4. pp. 440-443.
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