Buccal adherence of Pseudomonas aeruginosa in patients with cystic fibrosis under long-term therapy with azithromycin.
BACKGROUND
The oropharyngeal barrier is an innate host defence mechanism to prevent bacterial Lung infection. A compromised barrier function is observed in patients with cystic fibrosis (CF) who are chronically infected with Pseudomonas aeruginosa. Macrolides are assumed to modify host defence. We investigated the oropharyngeaL barrier function in CF patients treated with azithromycin (AZM).


METHODS
In a prospective study, eleven chronically infected children with CF were treated with longterm low-dose AZM. The oropharyngeal barrier function was assessed by adherence of P. aeruginosa (strain PACF 12-1) to buccal epithelial cells of the patients before and after therapy.


RESULTS
The mean (standard deviation, SD) buccaL adherence before therapy was markedly high with 8.0 (4.8) bacteria/cell. Following therapy with AZM adherence decreased in all patients by 70% or 5.6 to 2.4 (1.1) bacteria/cell (p = 0.007), representing close to normal LeveLs (1.2 +/- 0.6).


CONCLUSIONS
Long-term low-dose AZM therapy may improve the compromised oropharyngeaL barrier function in patients with CF, opening new perspectives for early treatment of P. aeruginosa infection in CF.
Baumann
U
U
Dept. of Pediatric Pneumology and Neonatology, Hannover Medical School, Germany. baumann.ulrich@mh-hannover.de
Fischer
J J
JJ
Gudowius
P
P
Lingner
M
M
Herrmann
S
S
Tümmler
B
B
von der Hardt
H
H
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D017963:Azithromycin / Q000008:administration & dosage* / Q000627:therapeutic use; D001422:Bacterial Adhesion; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology* / Q000503:physiopathology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D009055:Mouth; D009061:Mouth Mucosa / Q000382:microbiology*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D011550:Pseudomonas aeruginosa / Q000502:physiology*
D000900:Anti-Bacterial Agents; D017963:Azithromycin