Chronic pulmonary infections contribute significantly to the morbidity and mortality of patients with CF. The primary pathogens are Pseudomonas aeruginosa (PA) and Staphylococcus aureus. Hemophilus influenzae has been isolated from a significant number of patients also. A number of the β-lactam and aminoglycoside antibiotics reportedly have altered pharmacokinetic variables in CF. Therapy of acute pulmonary deterioration consists of intravenous antibiotics for two weeks. Antibiotic selection is based on culture and sensitivity results. Currently, the combination of a broad-spectrum penicillin and an aminoglycoside seems to provide the best results. Prophylactic antibiotics are effective if the primary isolates are sensitive to the agents used. Chronic PA infections are problematic because effective oral agents are not available. Aerosolized antibiotics do not improve results over adequate systemic therapy for acute exacerbations. Questions regarding optimal dosages, frequency, and duration of therapy remain.
BowmanBHMangosJA. Current concepts in genetics: Cystic fibrosis. N Engl J Med1976; 294: 937–8.
2.
AndersenDH. Cystic fibrosis of the pancreas and its relation to celiac disease. Am J Dis Child1938; 56: 344–99.
3.
DavisPBDi Sant'AgnesePA. A review. Cystic fibrosis at forty—quo vadis?Pediatr Res1980; 14: 83–7.
4.
WoodREBoatTFDoershukCF. Cystic fibrosis. Am Rev Respir Dis1976; 113: 833–77.
5.
Di Sant'AgnesePADavisPB. Research in cystic fibrosis. N Engl J Med1976; 295: 481–5, 534–9, 597–602.
6.
HuangNN. Guide to drug therapy in patients with cystic fibrosis. Atlanta, GA: The Cystic Fibrosis Foundation, 1974.
7.
KuzemkoJA. Evolution of lung disease in cystic fibrosis. Lancet1983; 1: 448–9.
8.
MarksMI. The pathogenesis and treatment of pulmonary infections in patients with cystic fibrosis. J Pediatr1981; 98: 173–9.
9.
MearnsMBHuntGHRushworthR.Bacterial flora of respiratory tract in patients with cystic fibrosis, 1950–1971. Arch Dis Child1972; 47: 902–27.
10.
MaconeABPierGBPenningtonJE, Mucoid Escherichia coli in cystic fibrosis. N Engl J Med1981; 304: 1445–9.
11.
MayJRHerrickNCThompsonD.Bacterial infection in cystic fibrosis. Arch Dis Child1972; 47: 908–12.
12.
DeforestALaraya-CuasayLRGregoryJE, Association of viral and mycoplasma infections with lower respiratory tract disease in patients with cystic fibrosis (abstract). Pediatr Res1972: 6: 388.
13.
DoggettRG. Incidence of mucoid Pseudomonas aeruginosa from clinical sources. Appl Microbiol1969; 18: 936–7.
14.
SlackMPENicholasWW. The penetration of antibiotics through sodium alginate and through the exopolysaccharide of a mucoid strain ofPseudomonas aeruginosa. Lancet1981; 2: 502–3.
15.
GovanJRWFyfeJAMMcMillanC.The instability of mucoid Pseudomonas: Fluctuation test and improved stability of the mucoid form in shaken culture. J Gen Microbiol1979; 110: 229–32.
GovanJRWFyfeJAM. Mucoid Pseudomonas aeruginosa and cystic fibrosis: Resistance of the mucoid form to carbenicillin, flucloxacillin, and tobramycin and the isolation of mucoid variants in vitro. J Antimicrob Agents Chemother1978; 4: 233–40.
18.
DemkoCAThomassonMJ. Effect of mucoid property on antibiotic susceptibility ofPseudomonas aeruginosa. Curr Microbiol1980; 4: 69–73.
19.
MarkowitzSMMacrinaFLPhibbPV. Antimicrobial susceptibility of mucoid Pseudomonas aeruginosa and their spontaneously occurring non-mucoid derivatives. J Antimicrob Chemother1980; 6: 251–60.
20.
IrvinRTGovanJWRFyfeJAMCostertonJW. Heterogeneity of antibiotic resistance in mucoid isolates of Pseudomonas aeruginosa obtained from cystic fibrosis patients: Role of outer membrane proteins. Antimicrob Agents Chemother1981; 19: 1056–63.
21.
LamJChanRLamkCostertonJW. Production of mucoid microcolonies by Pseudomonas aeruginosa within infected lungs in cystic fibrosis. Infect Immun1980; 28: 546–56.
22.
MayburyBABlessing-MooreJDe WitSALewistonNJYeagerAS. Antimicrobial susceptibilities of rough, smooth, and mucoid colony types of pseudomonas isolated from cystic fibrosis patients. Antimicrob Agents Chemother1979; 15: 494–6.
23.
WientzenRPrestidgeCBKramerRIMcCrackenGHNelsonJD. Acute pulmonary exacerbations in cystic fibrosis. A double-blind trial of tobramycin and placebo therapy. Am J Dis Child1980; 134: 1134–8.
24.
HyattACChippBEKumorKMMellitsEDLietmanPSRosensteinBJ. A double-blind controlled trial of anti-pseudomonas chemotherapy of acute respiratory exacerbations in patients with cystic fibrosis. J Pediatr1981; 99: 307–11.
25.
Loening-BauckeVAMischlerEMyersMG. A placebo-controlled trial of cephalexin therapy in the ambulatory management of patients with cystic fibrosis. J Pediatr1979; 95: 630–7.
26.
HodsonMEPenkethARLBattenJC. Aerosol carbenicillin and gentamicin treatment of Pseudomonas aeruginosa infection in patients with cystic fibrosis. Lancet1981; 2: 1137–9.
27.
ScribnerRKMarksMIWeberAHTarpayMMWelchDF. Activities of various beta-lactams and aminoglycosides, alone and in combination, against isolates of Pseudomonas aeruginosa from patients with cystic fibrosis. Antimicrob Agents Chemother1982; 21: 939–43.
28.
YuVLVickersRMZuravleffJJ. Comparative susceptibilities of Pseudomonas aeruginosa to 1-oxacephalosporin (Ly 127935) and eight other antipseudomonal antimicrobial agents (old and new). Antimicrob Agents Chemother1980; 17: 96–8.
29.
PrinceASNeuHC. Activities of new beta-lactam antibiotics against isolates of Pseudomonas aeruginosa from patients with cystic fibrosis. Antimicrob Agents Chemother1981; 20: 545–6.
30.
MuytjensHLVan De RepeJ.Comparative activities of 13 beta-lactam antibiotics. Antimicrob Agents Chemother1982; 21: 925–34.
31.
MelbyKMidtuedTDahlO.A comparison of the in vitro activity of tobramycin and gentamicin against 6042 clinical isolates. Chemotherapy1979; 25: 286–95.
32.
NewHC. Carbenicillin and ticarcillin. Med Clin North Am1982; 66: 61–77.
33.
RussoJRussoME. Comparative review of two new wide-spectrum penicillins: Mezlocillin and piperacillin. Clin Pharm1982; 1: 207–16.
34.
MastellaGAgostiniMBarloccoG, Alternative antibiotics for the treatment of pseudomonas infections in cystic fibrosis. J Antimicrob Chemother1983; 12 (suppl): 297–311.
35.
BraudeAI. Microbial susceptibility to drugs. In: SmithLH, ed. Antimicrobial drug therapy—major problems in internal medicine. Philadelphia:WB Saunders, 1976: 39–56.
36.
KucersABennettN McK, The use of antibiotics. 3rd ed.Philadelphia: JB Lippincott, 1979.
37.
GribbleMJChowAW. Erythromycin. Med Clin North Am1982; 66: 79–89.
38.
NewHC. Antistaphylococcal penicillins. Med Clin North Am1982; 66: 51–60.
39.
NeuHCFuKP, Cefaclor: In vitro spectrum of activity and beta-lactamase stability. Antimicrob Agents Chemother1978; 13: 584–8.
40.
DabernatHJDelmasC.Comparative activity of cefotaxime and selected β-lactam antibiotics against Haemophilus influenzae and aerobic gram-negative bacilli. Rev Infect Dis1982; 4 (suppl): 401–5.
41.
MoutonRP. Choice of an aminoglycoside. J Antimicrob Chemother1980; 6: 166–8.
42.
BaltchALHammerRPSutphenN.Pseudomonas aeruginosa bacteremia susceptibility of 100 blood culture isolates to seven antimicrobial agents and its clinical significance. J Lab Clin Med1979; 94: 201–14.
43.
PriceKEDefuriaMDPursianoTA. Amikacin—an aminoglycoside with marked activity against antibiotic-resistant clinical isolates. J Infect Dis1976; 34 (suppl): 249–61.
44.
EickhoffTCMarksMI. Carbenicillin in therapy of systemic infections due to pseudomonas. J Infect Dis1970; 122 (suppl): 84–6.
45.
NelsonJD. Carbenicillin therapy of infections due to pseudomonas in children. J Infect Dis1970; 122 (suppl): 48–58.
46.
EliopoulusGMMoelleringRC. Azlocillin, mezlocillin, and piperacillin: New broad-spectrum penicillins. Ann Intern Med1982; 97: 755–60.
47.
SmithLGSensakovicJ.Trimethoprim-sulfamethoxazole. Med Clin North Am1982; 66: 143–56.
48.
PenningtonJE. Penetration of antibiotics into respiratory secretions. Rev Infect Dis1981; 3: 67–73.
49.
SaggersBALawsonD.In vivo penetration of antibiotics into sputum in cystic fibrosis. Arch Dis Child1968; 43: 404–9.
50.
McCraeWMRaeburnJAHansonEJ. Tobramycin therapy of infections due to Pseudomonas aeruginosa in patients with cystic fibrosis: Effect of dosage and concentration of antibiotic in sputum. J Infect Dis1976; 134 (suppl): 191–3.
51.
MarksMIPrenticeRSwarsonRCottonEKEichkoffTC. Carbenicillin and gentamicin: Pharmacologic studies in patients with cystic fibrosis and pseudomonas pulmonary infections. J Pediatr1971; 79: 822–8.
52.
ParryMFNeuHCMerlinoMGaerlanPFOresCNDenningCR. Treatment of pulmonary infections in patients with cystic fibrosis: A comparative study of ticarcillin and gentamicin. J Pediatr1977; 90: 144–8.
53.
PenningtonJEReynoldsHY. Concentrations of gentamicin and carbenicillin in bronchial secretions. J Infect Dis1973; 128: 63–8.
54.
PenningtonJEReynoldsHY. Tobramycin in bronchial secretions. Antimicrob Agents Chemother1973; 4: 299–301.
55.
KlasterskyJThysJPMombelliG.Comparative studies of intermittent and continuous administration of aminoglycosides in the treatment of broncho-pulmonary infections due to gram-negative bacteria. Rev Infect Dis1981; 3: 74–83.
OdioWVan LaerEKlasterskyJ.Concentrations of gentamicin in bronchial secretions after intramuscular and endotracheal administration. J Clin Pharmacol1975; 15: 518–24.
58.
MalmborgASAlfredssonHKusoffskyEStrandvikB.Azlocillin and gentamicin in respiratory tract infections with Pseudomonas aeruginosa in patients with cystic fibrosis. Scand J Infect Dis1981; 29 (suppl): 64–9.
59.
WongGAPierceTHGoldsteinEHoeprichPD. Penetration of antimicrobial agents into bronchial secretions. Am J Med1975; 59: 219–23.
60.
ThysJPMouwadGKlasterskyJ.Concentrations of netilmicin in bronchial secretions and serum during intermittent vs continuous infusion: A cross-over study in humans (letter). J Infect Dis1979; 140: 634.
61.
AlexanderMRBerglandEMKasikJEFoxAChinnWM. The concentration of tobramycin in bronchial secretions. Chest1979; 75: 675–8.
62.
AlexanderMRSchoellJHicklinGKasikJEColemanD.Bronchial secretion concentrations of tobramycin. Am Rev Respir Dis1982; 125: 208–9.
Bergogne-BerezinEMorelCPierreJMonrocgNDournouoPBenardY.Penetration of cefotaxime into bronchial secretions. Rev Infect Dis1982; 4 (suppl): 392–5.
65.
BrunYForeyFGamondesJPTebibABruneJFleuretteJ.Levels of erythromycin in pulmonary tissue and bronchial mucus compared to those of amoxycillin. J Antimicrob Chemother1981; 8: 459–66.
66.
VellutiGSchioppacassiGCurcioLCoviM.Concentrations of semi-synthetic penicillins in the plasma and in the expectoration, administered by means of intermittent vein perfusion. Respiration1981; 41: 276–80.
67.
PechereJCDugalR.Clinical pharmacokinetics of aminoglycoside antibiotics. Clin Pharmacokinet1979; 4: 170–99.
68.
MarlinGEBurgessKRBurgoyneJFunnelGRGuinnessMDG. Penetration of piperacillin into bronchial mucosa and sputum. Thorax1981; 36: 774–80.
StewartSMAndersonIMEJonesGRCalderMA. Amoxycillin levels in sputum, serum, and saliva. Thorax1974; 29: 110–4.
71.
MaesenFPVBeeuwkesHDaviesBIBuytendijkHJBrombacherPJWessmanJ.Bacampicillin in acute exacerbations of chronic bronchitis, a dose-range study. J Antimicrob Chemother1976; 2: 279–85.
72.
JuskoWJMosovichLLGerbrachtLMMattarMEYaffeSJ. Enhanced renal excretion of dicloxacillin in patients with cystic fibrosis. Pediatrics1975; 56: 1038–44.
73.
YaffeSJGerbrachtLMMosovichLLMattarMGDanishMJuskoWJ. Pharmacokinetics of methicillin in patients with cystic fibrosis. J Infect Dis1977; 135: 828–31.
74.
MichalsenHBerganT.Pharmacokinetics of antibiotics in children with cystic fibrosis with particular reference to netilmicin. Acta Paediatr Scand1982; 301 (suppl): 101–5.
PrinceASNeuHC. Use of piperacillin, a semisynthetic penicillin, in the therapy of acute exacerbations of pulmonary disease in patients with cystic fibrosis. J Pediatr1980; 97: 148–51.
77.
ReedMDBertinoJSAronoffSCHusakMPBlumerJLSpeckWT. Efficacy and pharmacokinetics of piperacillin in patients with cystic fibrosis. 21st Interscience Conference on Antimicrobial Agents and Chemotherapy, November, Chicago, Illinois, 1981.
78.
KercsmarCMSternRCReedMDMyersCMMurdellDBlumerJL. Ceftazidime in cystic fibrosis: Pharmacokinetics and therapeutic response. J Antimicrob Chemother1983; 12 (suppl): 289–95.
79.
PadoanRBrienzaACrossignaniRM, Ceftazidime in treatment of acute pulmonary exacerbations in patients with cystic fibrosis. J Pediatr1983; 103: 320–4.
80.
ArvidssonAAlvanGStrandvikB.Difference in renal handling of cefsulodin between patients with cystic fibrosis and normal subjects. Acta Paediatr Scand1983; 72 (suppl): 293–4.
81.
KearnsGLHillmanBCWilsonJT. Dosing implications of altered gentamicin disposition in patients with cystic fibrosis. J Pediatr1982; 100: 312–8.
82.
VogelsteinBKowarskiAALietmanPS. Pharmacokinetics of amikacin in children. J Pediatr1977; 91: 333–9.
83.
BergUKusoffskyEStrandvikB.Renal function in cystic fibrosis with special references to the renal sodium handling. Acta Pediatr Scand1982; 71 (suppl): 833–8.
84.
SpinoMChaiRIslesAFBalfeJWMacleodSM. Renal function in cystic fibrosis (abstract). Clin Pharmacol Ther1983; 33: 244.
85.
FinkelsteinEHallK.Aminoglycoside clearance in patients with cystic fibrosis. J Pediatr1979; 94: 163–4.
86.
MacdonaldNEAnasNGPetersonRGSchwartzRHBrooksJGPowellKR. Renal clearance of gentamicin in cystic fibrosis. J Pediatr1983; 103: 985–90.
87.
KellyHBMenendezRFanLMurphyS.Pharmacokinetics of tobramycin in cystic fibrosis. J Pediatr1982; 100: 318–21.
88.
MichalsenHBérganT.Pharmacokinetics of netilmicin in children with and without cystic fibrosis. Antimicrob Agents Chemother1981; 19: 1029–31.
89.
MarksMIVoseAHammerbergSDugalR.Clinicopharmacological studies of sisomicin in ill children. Antimicrob Agents Chemother1978; 13: 753–8.
BravoMEArancibiaAJarpaSCarpentierPMJahnAN. Pharmacokinetics of gentamicin in malnourished infants. Eur J Clin Pharmacol1982; 21: 499–504.
92.
PenningtonJEDaleDCReynoldsHYMaclowryJD. Gentamicin sulfate pharmacokinetics: Lower levels of gentamicin in blood during fever. J Infect Dis1975; 132: 270–5.
93.
ZaskeDESawchukRJGerdingDNStrateRG. Increased dosage requirements of gentamicin in burn patients. J Trauma1976; 16: 824–8.
94.
BauerLABlouinRA. Amikacin pharmacokinetics in young men with pneumonia. Clin Pharm1982; 1: 353–5.
95.
QuintonPM. Suggestion of an abnormal anion exchange mechanism in sweat glands of cystic fibrosis patients. Pediatr Res1982; 16: 533–7.
96.
FishmanAP. State of the art: Chronic cor pulmonale. Am Rev Respir Dis1976; 114: 775–94.
97.
HirschfeldSSFlemingDGDoershukCLiebmanJ.Echocardiographic abnormalities in patients with cystic fibrosis. Chest1979; 75: 351–5.
98.
RosenthalAButtonLNKhawKT. Blood volume changes in patients with cystic fibrosis. Pediatrics1977; 59: 588–94.
99.
NoonePParsonsTMCPattisonJRSlackRCBGarfield-DaviesDHughesK.Experience in monitoring gentamicin therapy during treatment of serious gram-negative sepsis. Br Med J1974; 1: 477–81.
100.
WashingtonJA. The effects and significance of subminimal inhibitory concentrations of antibiotics. Rev Infect Dis1979; 1: 781–5.
101.
ZakOKradolferF.Effects of subminimal inhibitory concentrations of antibiotics in experimental infections. Rev Infect Dis1979; 1: 862–79.
102.
SawchukRJZaskeDE. Pharmacokinetics of dosing regimens which utilize multiple intravenous infusion. J Pharmacokinet Biopharm1976; 4: 183–95.
103.
CipolleRJSeifertRDZaskeDEStrateRG. Hospital acquired gram-negative pneumonias: Response rate and dosage requirements with individualized tobramycin therapy. Ther Drug Monitor1980; 2: 359–63.
104.
ZaskeDECipolleRJRotschaferJCSolemLDMosierNRStrateRG. Gentamicin pharmacokinetics in 1640 patients: Method for control of serum concentrations. Antimicrob Agents Chemother1982; 21: 407–11.
105.
ZaskeDEBootmanJLSolemLBStrateRG. Increased burn patient survival with individualized dosages of gentamicin. Surgery1982; 91: 142–9.
106.
RabinHRHarleyFLBryanLEElfringGL. Evaluation of a high dose tobramycin and ticarcillin treatment protocol in cystic fibrosis based on improved susceptibility criteria and antibiotic pharmacokinetics. In: Perspectives in cystic fibrosis. Proceedings of the 8th International Cystic Fibrosis Congress. Toronto, Canada, 1980: 370.
107.
FraserGLGrimesGRValentiAJ. Applied pharmacokinetics in acute exacerbations of Pseudomonas aeruginosa pneumonia in cystic fibrosis (letter). J Pediatr1982; 101: 792.
108.
BeaudryPHMarksMIMcDougallDDesmondKRangeR.Is antipseudomonas therapy warranted in acute respiratory exacerbations in children with cystic fibrosis?J Pediatr1980; 97: 144–7.
109.
MichalsenHBerganT.Azlocillin with and without an aminoglycoside against respiratory tract infections in children with cystic fibrosis. Scand J Infect Dis1981; 29 (suppl): 92–7.
110.
MichalsenHBerganT.Azlocillin in respiratory tract infections with Pseudomonas aeruginosa in children with cystic fibrosis. Chemotherapy1980; 26: 135–40.
111.
SimonGLSnydamDRTallyFPGorbachSL. Clinical trial of piperacillin with acquisition of resistance by pseudomonas and clinical relapse. Antimicrob Agents Chemother1980; 18: 167–70.
112.
PerminHKochCHoibyNChristensenHOMollerAFMollerS.Ceftazidime treatment of chronic Pseudomonas aeruginosa respiratory tract infection in cystic fibrosis. J Antimicrob Chemother1983; 12 (suppl): 313–23.
113.
MollerNEHoibyN.Antibiotic treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. Scand J Infect Dis1981; 24 (suppl): 87–91.
114.
FriisB.Chemotherapy of chronic infections with mucoid Pseudomonas aeruginosa in lower airways of patients with cystic fibrosis. Scand J Infect Dis1979; 11: 211–7.
115.
KrausePJYoungLSCherryJOOsherABSpencerMJBrysonYJ. The treatment of exacerbations of pulmonary disease in cystic fibrosis: Netilmicin compared with netilmicin and carbenicillin. Curr Ther Res1979; 25: 609–17.
116.
McLaughlinFJMatthewsWJStriederDJSullivanBTanejaAMurphyPGoldmanDA. Clinical and bacteriological responses to three antibiotic regimens for acute exacerbations of cystic fibrosis: Ticarcillin-tobramycin, azlocillin-tobramycin, and azlocillinplacebo. J Infect Dis1983; 147: 559–67.
117.
MartinAJSmalleyCAGeorgeRHHealingDGAndersenCM. Gentamicin and tobramycin compared in the treatment of mucoid pseudomonas lung infections in cystic fibrosis. Arch Dis Child1980; 55: 604–7.
118.
ParryMFNeuHC. A comparative study of ticarcillin plus tobramycin versus carbenicillin plus gentamicin for the treatment of serious infections due to gram negative bacilli. Am J Med1978; 64: 961–6.
119.
LauWKYoungLSOsherABDooleyRR. Amikacin therapy of exacerbations of Pseudomonas aeruginosa infections in patients with cystic fibrosis. Pediatrics1977; 60: 372–7.
120.
MollerNGKochCVesterhaugeSJensenK.Treatment of pulmonary Pseudomonas aeruginosa infection in cystic fibrosis with cefsulodin. Scand J Infect Dis1982; 14: 207–11.
121.
DenningCRParkSGreceCA, Continuous vs. intermittent oral antibiotics in the management of patients with cystic fibrosis (abstract). In: Cystic Fibrosis Club Abstracts. Atlanta: Cystic Fibrosis Foundation, 1977; 18: 13.
122.
SzaffMHoibyNFlensborgEW. Frequent antibiotic therapy improves survival of cystic fibrosis patients with chronic Pseudomonas aeruginosa infection. Acta Paediatr Scand1983; 72: 651–7.
123.
BarachALMolomutMSorokaM.Inhalation of promin in experimental tuberculosis. Am Rev Tuberc1942; 46: 268–76.
124.
SpierRWitebskyEPaineJR. Aerosolized pancreatic dornase and antibiotics in pulmonary infections. Use in patients with postoperative and nonoperative infections. JAMA1961; 178: 878–80.
125.
BilodeauMRoyJCGirouxM.Studies of absorption of kanamycin by aerosolization. Ann NY Acad Sci1966; 132: 870–8.
126.
LifschitzMIDenningCR. Safety of kanamycin aerosol. Clin Pharmacol Ther1971; 12: 91–5.
127.
DickieKJDe GrootWJ. Ventilatory effects of aerosolized kanamycin and polymixin. Chest1973; 63: 694–7.
128.
LourencoRVCotromanesE.Clinical aerosols: II. Therapeutic aerosols. Arch Intern Med1982; 142: 2299–308.
129.
KlasterskyJGeuningCMouawadE, Endotracheal gentamicin in bronchial infections in patients with tracheostomy. Chest1972; 61: 117–20.
130.
BoxerbaumBPittmanSDoershukCFSternRCMatthewsLW. Use of gentamicin in children with cystic fibrosis. J Infect Dis1971; 124 (suppl): 293–5.
131.
HuangNNHillerGJMacriCMCapitanioMCundyKR. Carbenicillin in patients with cystic fibrosis: Clinical pharmacology and therapeutic evaluating. J Pediatr1971; 78: 338–45.
132.
HoffGESchiotzPOPaulsenJ.Tobramycin treatment of Pseudomonas aeruginosa infections in cystic fibrosis. Scand J Infect Dis1974; 6: 333–7.
133.
PierceAKSanfordJP. Bacterial contamination of aerosols. Arch Intern Med1973; 131: 156–9.
134.
KuhnRJLubinHLJonesPRNahataMC. Bacterial contamination of aerosol solutions used to treat cystic fibrosis. Am J Hosp Pharm1982; 39: 308–9.
135.
RuckerRWHarrisonGM. Outpatient intravenous medications in the management of cystic fibrosis. Pediatrics1974; 54: 358–60.
136.
IsenbergJNOsherAB. Potential value of longterm outpatient administration of antibiotics and parenteral nutrition through a central venous catheter in cystic fibrosis (abstract). In: Cystic Fibrosis Club Abstracts. Atlanta: Cystic Fibrosis Foundation.1982; 23: 55.
137.
FergusonRLRosettWHodgesGRBarnesWG. Complications with heparin-lock needles, a prospective evaluation. Ann Intern Med1976; 85: 583–6.
138.
CouchonnalGJHodgesGRBarnesWGElmetsCAClarkGM. Complications with heparin-lock needles. JAMA1979; 242: 2098–100.
139.
AggerWAMakiDG. Septicemia from heparin-lock needles (letter). Ann Intern Med1977; 86: 657.
140.
HodderSLSternRC. Safety of long duration intravenous heparin-lock needles for administration of antibiotics to cystic fibrosis patients. J Pediatr1981; 99: 312–4.
141.
O'NeillTJTierneyLMProuixRJ. Heparin lock-induced alterations in the activated partial thromboplastin time. JAMA1974; 227: 1297–8.
142.
HolfordNHGVozehSCoatesPPowellJRThiercelinJFUptonR.More on heparin lock (letter). N Engl J Med1976; 294: 448.
143.
HansonRLGrantAMMajorsKR. Heparin-lock maintenance with ten units of sodium heparin in one milliliter of normal saline solution. Surg Gynecol Obstet1976; 142: 373–6.
144.
NielsenABSorenE.The use of gentamicin intravenously. Acta Pathol Microbiol Scand1973; 241 (suppl): 23–9.
MendelsonJPortnoyJDickVBlackM.Safety of the bolus administration of gentamicin. Antimicrob Agents Chemother1976; 9: 633–8.
147.
GillettAPFalkRHAndrewsJWiseRMelikianV.Rapid intravenous injection of tobramycin: Suggested dosage schedule and concentrations of serum. J Infect Dis1976; 134 (suppl): 110–13.
148.
DobbsSMMawerGE. Intravenous injection of gentamicin and tobramycin without impairment of hearing. J Infect Dis1976; 134 (suppl): 114–17.
149.
ReddingGJRestucciaRCottonEKBrooksJG. Serial changes in pulmonary functions in children hospitalized with cystic fibrosis. Am Rev Respir Dis1982; 126: 31–6.
150.
HenJDolanTF. The optimal length of treatment for hospitalized patients with cystic fibrosis (letter). Am Rev Respir Dis1982; 126: 939.
