Treatment of Chronic Pseudomonas Aeruginosa Infection in Cystic Fibrosis Patients with Ceftazidime and Tobramycin

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Abstract
Minimum inhibitory concentration (MIC) and 50% inhibitory concentration (IC50) of ceftazidime, cefsulodin, cefotaxime, moxalactam, azlocillin, carbenicillin, netilmicin and tobramycin against 90 strains of P. aeruginosa isolated from cystic fibrosis (CF) patients were determined by the agar plate dilution method. Ceftazidime was most active of the antibiotics in vitro; the geometric mean of IC50 was 0.2 and of MIC 0.4 .mu.g/ml. Eleven CF patients suffering from P. aeruginosa infection were treated with 14 day courses of ceftazidime (100 mg/kg per 24 h) and tobramycin (10 mg/kg per 24 h). P. aeruginosa was only temporarily eradicated in 1 of the patients; but a significant improvement of respiratory function and a significant fall in white blood cell count were recorded in the patients during chemotherapy. There was no development of resistant strains against ceftazidime during treatment; no side-effects were observed. Ceftazidime is a promising new antimicrobial agent with high in vitro activity which deserves further in vivo evaluation in CF patients.