Controlled trial of ceftazidime vs. ticarcillin and tobramycin in the treatment of acute respiratory exacerbations in patients with cystic fibrosis.

A randomized controlled trial was undertaken to compare ceftazidime vs. the combination of ticarcillin and tobramycin in the treatment of acute respiratory exacerbations of mild to moderate severity in patients with cystic fibrosis. The two antibiotic regimens were equally effective in terms of clinical improvement: 16 of 17 in the ceftazidime group and 11 of 13 in the ticarcillin/tobramycin group were judged to be improved by the patients and attending physicians and were observed to show improvement in symptom scores, vital signs, body weight and pulmonary function. Ceftazidime was more effective bacteriologically in reducing colony counts of Pseudomonas aeruginosa in the sputum. Neither regimen affected Pseudomonas cepacia. Resistance to multiple antibiotics developed in six of 12 isolates of nonmucoid P. aeruginosa in patients receiving ticarcillin/tobramycin, which was significantly more than occurred in the ceftazidime group. There was no correlation between clinical and bacteriologic outcomes in either treatment group. No clinically important adverse effects were observed.