Update on treatment of pulmonary exacerbations in cystic fibrosis.
OBJECTIVE
This review will define pulmonary exacerbations in cystic fibrosis and explain their importance in the pathophysiology and progression of this condition. I will stress the importance of prevention, where this is possible, and prompt treatment, where prevention has failed. The management of chronic pulmonary infection with Pseudomonas aeruginosa will be discussed, together with other, less tenacious organisms.


RESULTS
Developments in the treatment of chronic pulmonary infection with P. aeruginosa include new data on antibiotic selection through sensitivity testing and alternative antibiotic dosing regimens. Therapies which target the P. aeruginosa biofilm will be discussed, including those which are currently in use (such as azithromycin) as well as those being evaluated in preclinical studies. Supportive care and the role of noninvasive ventilation are discussed.


CONCLUSIONS
The prevention and prompt treatment of pulmonary exacerbations is a central component of cystic fibrosis care.
Smyth
Alan
A
Division of Respiratory Medicine, Nottingham City Hospital, Nottingham, UK. alan.smyth@nottingham.ac.uk
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D003550:Cystic Fibrosis / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000382:microbiology* / Q000503:physiopathology* / Q000517:prevention & control; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D011550:Pseudomonas aeruginosa; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents