Treatment of early Pseudomonas aeruginosa infection in patients with cystic fibrosis.
OBJECTIVE
While Pseudomonas aeruginosa continues to be the major pathogen in cystic fibrosis lung disease, there is increasing evidence that antibiotic therapy initiated early after the onset of infection is an effective strategy to postpone chronic P. aeruginosa infection. There are also studies showing that early treatment can eradicate the organism in the majority of cases.


RESULTS
While comparative data for different treatment strategies are currently lacking, inhaled antibiotic therapy alone or in combination with ciprofloxacin has been shown to be efficacious. So far eradication of P. aeruginosa has not been associated with an increased risk of airway infection with other pathogens, but these studies have been performed in small cohorts. Additional information is also needed to clarify the optimal form and duration of therapy. Currently, there are two large studies ongoing to resolve some of these issues.


CONCLUSIONS
There is sufficient evidence that early antibiotic therapy against P. aeruginosa can clear the bacteria from the respiratory tract. While the negative effects of chronic P. aeruginosa infection are well documented, long-term benefits of this intervention on lung function is lacking. Observational studies suggest, however, that early intervention therapy is both beneficial and cost effective for cystic fibrosis patients.
Ratjen
Felix
F
Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada. felix.ratjen@sickkids.ca
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003550:Cystic Fibrosis / Q000150:complications*; D006801:Humans; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000209:etiology* / Q000517:prevention & control; D011550:Pseudomonas aeruginosa; D014031:Tobramycin / Q000627:therapeutic use; D014611:Vaccination
D000900:Anti-Bacterial Agents; D014031:Tobramycin