Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis.

Abstract

BACKGROUND:

Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8-93.0%. In this retrospective cohort study, we report the outcomes of AET in an adult population.

METHODS:

Adults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012. Choice of therapy, time to eradication and reinfection, and lung function (forced expiratory volume in 1 s (FEV1)) were determined.

RESULTS:

20 patients (median age 27 years) isolated P aeruginosa during the study period. 10 patients were treated with oral ciprofloxacin (median duration 6 weeks) and nebulised colomycin (median duration 3 months). 7 patients were treated with intravenous antipseudomonal antibiotics (median duration 14 days). 2 patients received other combinations of oral and inhaled antipseudomonal therapy and one patient received no therapy. AET was successful in 15 cases who received antipseudomonal therapy (79%). The median time to eradication was 1 month. The median time to reinfection with P aeruginosa was 43 months. There was no significant change in FEV1 after 12 months.

CONCLUSIONS:

Aggressive AET of new infection of P aeruginosa in adults is successful in the majority of patients and has similar efficacy to the reported efficacy in paediatric populations.

• Authors: S L Kenny, T D Shaw, D G Downey, J E Moore, J C Rendall, J S Elborn
• Journal: BMJ open respiratory research (BMJ Open Respir Res) Vol. 1 Issue 1 Pg. e000021 ( 2014) ISSN: 2052-4439 [Print] England
• PMID: 25478173 (Publication Type: Journal Article)