Trial reportArchives of disease in childhood1998
Efficacy, tolerance, and pharmacokinetics of once daily tobramycin for pseudomonas exacerbations in cystic fibrosis.
Trial report in Archives of disease in childhood, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Intravenous antibiotics for pulmonary exacerbations in people with cystic fibrosis.The Cochrane database of systematic reviews · 2025Pooled it
- Aminoglycosides: Single- or Multiple-daily Dosing? An Updated Qualitative Systematic Review of Randomized Trials on Toxicity and Efficacy.Current molecular medicine · 2024Pooled it
- Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis.The Cochrane database of systematic reviews · 2019Pooled it
- Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis.The Cochrane database of systematic reviews · 2017Pooled it
- Intravenous antibiotics for pulmonary exacerbations in people with cystic fibrosis.The Cochrane database of systematic reviews · 2015Pooled it
- Trial
- Tobramycin once- vs thrice-daily for elective intravenous antipseudomonal therapy in pediatric cystic fibrosis patients.Infection · 2009Trial
- Continuous versus intermittent infusions of ceftazidime for treating exacerbation of cystic fibrosis.Antimicrobial agents and chemotherapy · 2009Trial
- Pharmacokinetics of tobramycin in adults with cystic fibrosis: implications for once-daily administration.Antimicrobial agents and chemotherapy · 2000Trial
- Tobramycin pharmacokinetic and pharmacodynamic targets in people with cystic fibrosis.British journal of clinical pharmacology · 2026Review
- Pharmacokinetic and Pharmacodynamic Optimization of Antibiotic Therapy in Cystic Fibrosis Patients: Current Evidences, Gaps in Knowledge and Future Directions.Clinical pharmacokinetics · 2021Review
- Safety of intravenous tobramycin in combination with a variety of anti-pseudomonal antibiotics in children with cystic fibrosis.SAGE open medicine · 2017Article
- Duration of intravenous antibiotic therapy in people with cystic fibrosis.The Cochrane database of systematic reviews · 2016Review
- Extended-Interval Aminoglycoside Use in Cystic Fibrosis Exacerbation in Children and Young Adults: A Prospective Quality Improvement Project.Global pediatric health · 2016Article
- Pharmacokinetics and pharmacodynamics of aerosolized antibacterial agents in chronically infected cystic fibrosis patients.Clinical microbiology reviews · 2014Review
- Pharmacokinetic and pharmacodynamic optimisation of intravenous tobramycin dosing among children with cystic fibrosis.Journal of pharmacokinetics and pharmacodynamics · 2014Article
- Is the improvement of CF patients, hospitalized for pulmonary exacerbation, correlated to a decrease in bacterial load?PloS one · 2013Article
- Evaluation of serum concentrations achieved with an empiric once-daily tobramycin dosage regimen in children and adults with cystic fibrosis.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2012Article
- National survey of extended-interval aminoglycoside dosing in pediatric cystic fibrosis pulmonary exacerbations.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2011Article
- Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare once daily with thrice daily tobramycin for treatment of Pseudomonas aeruginosa infection in patients with cystic fibrosis.
design22 patients with cystic fibrosis, mean (SD) age 11 (3.4) years (range 5.6-19.3), with pulmonary pseudomonas exacerbations were randomly assigned to receive a 14 day course of tobramycin (15 mg/kg/day) either in three infusions (group A) (n = 10) or a single daily infusion (group B) (n = 12), combined with ceftazidime (200 mg/kg/day as three intravenous injections). Efficacy was assessed by comparison of pulmonary, nutritional, and inflammatory indices on days 1 and 14. Cochlear and renal tolerance were assessed on days 1 and 14. Tobramycin concentration was measured in serum and sputum 1, 2, 3, 4, 8, and 24 hours after the start of the infusion. Analysis was by non-parametric Wilcoxon test.
resultsVariables improving (p < 0.05) in both groups A and B were, respectively: weight/height (+4% and +3.1%), plasma prealbumin (+66 and +63 mg/l), forced vital capacity (FVC) (+14% and +11%), forced expiratory volume in one second (+15% and +14%), and forced expiratory flow between 25% and 75% of FVC (+13% and +21%). Improvement was not significantly different between groups. Renal and cochlear indices remained within the normal range. Serum peak concentration of tobramycin on day 1 was 13.2 (7.1) mg/l in group A and 42.5 (11.2) mg/l in group B (p < 0.001); serum trough was 1.1 (0.8) mg/l in group A and 0.3 (0.2) mg/l in group B (p < 0.01). Tobramycin concentrations in sputum were two to three times higher in group B than group A.
conclusionsOnce daily tobramycin combined with three injections of ceftazidime is safe and effective for the treatment of pseudomonas exacerbations in cystic fibrosis patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.