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A double blind controlled trial of Becotide (beclomethasone diproprionate) inhalations was carried out for treating cystic fibrosis patients with chronic P. aeruginosa lung infection to determine its efficacy and safety. The aim of the treatment was to diminish the inflammatory response in the lungs of these patients, a response which is initiated by an allergic type III reaction. Pulmonary inflammation was evaluated by measurements of proteolytic activity, albumin concentration and immune complex activity in the sputum sol-phase before, during, and after the 16 weeks the trial lasted. 26 cystic fibrosis patients participated (13 received Becotide and 13 placebo) and the results showed that local steroids have no effect on the inflammatory response in the lungs of cystic fibrosis patients with chronic P. aeruginosa lung infection. No adverse effects were demonstrated. There was, however, a significant increase in the inflammatory parameters for all 26 cystic fibrosis patients when the trial period was over, compared to the insidious pulmonary destruction which takes place in the lungs of these patients, and it corresponded to a significant decrease (p less than 0.05) in forced vital capacity which took place at the same time. Therefore, chronic P. aeruginosa lung infection in these patients should be treated as efficiently as possible.

SUMMARY 1 Sixty children with febrile convulsions under the age of 3 were maintained on prophylactic phenobarbital in a dose of 3–4 mg/kg given in divided dosage twice daily. Double the ordinary dose was given for the first 2 days to achieve a therapeutic serum concentration within a few days. The serum concentration was checked before discharge from the hospital and at intervals of 1–3 months for 6 months. 2 Among 27 children with a serum concentration habitually at or over 16 mg/1, 1 had a brief febrile convulsion within 6 months (serum concentration not determined at the time of the convulsion). When the serum concentration was habitually or at the time of the convulsion at or under 15 mg/1, the incidence of recurrences was the same as in an untreated group, 21 % within 6 months. 3 It did not prove difficult to persuade the mothers to give the medication faithfully. There were few complications: hypersensitive rash in 1, emotional instability in 1 and acute intoxication in 2. If a few simple precautions are observed, prophylactic medication with phenobarbital is harmless and is effective in preventing recurrences. RESUME 1 Soixante enfants, âges sous 3 ans et ayant des convulsions febriles, ont ete maintenus a un traitement prophylactique, avec du phenobarbital a des doses de 3–4 mg/kg par jour. Pendant les 2 premiers jours, on a donne le double de la dose habituelle pour obtenir en quelques jours une concentration therapeutique dans le serum. Les concentrations seriques ont ete controlees apres l'admission a l'hopital et a des intervalles de un a trois mois pendant une periode de 6 mois. 2 Chez les sujets dont la concentration serique habituelle ou au moment des convulsions etait inferieure a 15 mg/1, les crises se sont reproduites avec un pourcentage identique a celui d'un groupe non-traite, c'est-a-dire 21 % au cours d'une periode d'observation de 6 mois. Par contre, chez 27 enfants qui avaient une concentration serique habituelle egale ou superieure a 16 mg/1, 1 seulement a presente une convulsion febrile de breve duree en 6 mois (au moment de la convulsion, on n'a pas determine la concentration serique). 3 Il s'est avere qu'il n'est pas difficile de persuader les meres de donner le traitement de facon adequate. II y a eu peu de complications: un rash hyper-sensitif dans 1 cas, une instabiliteemotive dans un cas et une intoxication aigue dans 2 cas. Si on prend quelques precautions simples, le traitement prophylactique par phenobarbital est sans danger et efficace pour prevenir la reapparition des crises.