Regimens for eradicating early Pseudomonas aeruginosa infection in children do not promote antibiotic resistance in this organism.
BACKGROUND
This study was designed to address the concern that intensive regimens to eradicate early Pseudomonas aeruginosa infection in patients with cystic fibrosis may lead to the emergence of antibiotic-resistant isolates.


METHODS
Data was analysed retrospectively over a 10 year period at the Leeds Regional Paediatric Cystic Fibrosis Centre. All patients with first-ever isolation of P. aeruginosa who successfully completed an eradication regimen were included. Antibiotic sensitivities of P. aeruginosa were compared between initial and subsequent re-isolations in patients where eradication was successful and in those where treatment had failed.


RESULTS
Forty one patients with first acquisitions for P. aeruginosa and who completed eradication treatment were identified. Eradication treatments consisted of oral, intravenous, nebulised antibiotics or a combination of these. The antibiotic sensitivity of P. aeruginosa in first growths was high and remained so on subsequent re-isolations. A repeated measures logistic model found no significant difference with time of isolation. There was no statistically significant difference in antibiotic sensitivity between P. aeruginosa isolated after successful and failed eradication.


CONCLUSIONS
Repeated intensive regimens for P. aeruginosa eradication did not result in a significant increase in overall antibiotic resistance between initial and subsequent growths of this organism over the period of this study.
Ho
Sheng-Ang
SA
Department of Paediatrics, Macclesfield General Hospital, Macclesfield, SK10 3BL, UK. Ang.Ho@echeshire-tr.nwest.nhs.uk
Lee
Tim W R
TW
Denton
Miles
M
Conway
Steven P
SP
Brownlee
Keith G
KG
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003550:Cystic Fibrosis / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000502:physiology*; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents