Addendum: Management of Cystic Fibrosis

Prepared by: Ji Keon LOOI

This is the very informative summary that I promised to upload.

From http://www.childsdoc.org/fall97/cf/fig2.jpg

Below is the discussion on the antibiotics prescribed to Georgia. Only relevant information is included to avoid overloading our meddies with an avalanche of information which might inevitably cause the burnout rate to increase.

Cannot be Emphasised More (Must know-lah)

Pseudomonas aeruginosa is the major culprit in causing complications in patients with cystic fibrosis.

Nice-to-know
Tobramycin

• Tobramycin sulfate is an aminoglycoside antibiotic used to treat various types of bacterial infections, particularly Gram-negative infections.


• Patients with cystic fibrosis will often take an inhalational form (Tobi®) for suppression of Pseudomonas aeruginosa infections. Tobramycin is also combined with dexamethasone as an ophthalmic solution (TobraDex®).

Ticarcillin

• Ticarcillin is a carboxypenicillin. It is almost invariably sold and used in combination with clavulanate as Timentin®.


• Because it is a penicillin, it also falls within the larger class of beta-lactam antibiotics. Its main clinical use is as an injectable antibiotic for the treatment of gram negative bacteria, in particular, Pseudomonas aeruginosa.


• Ticarcillin's antibiotic properties arise from its ability to prevent cross-linking of peptidoglycan during cell wall synthesis when the bacteria tries to divide, causing death.
  

Ciprofloxacin

• Ciprofloxacin is a broad-spectrum antibiotic that is active against both Gram-positive and Gram-negative bacteria. It functions by inhibiting topoisomerase, an enzyme necessary to separate replicated DNA, thereby inhibiting cell division.
  
• The major adverse effect seen with use is gastrointestinal irritation, common with many antibiotics. Because of its general safety, potency and broad spectrum activity, ciprofloxacin was initially reserved as a drug of last resort for use on difficult and antibiotic-resistant infections.

The information for the above drugs is all derived from http://en.wikipedia.org.