The relevance of the polymicrobial nature of airway infection in the acute and chronic management of patients with cystic fibrosis.
A comprehensive analysis of the airway microbiome in cystic fibrosis (CF) has revealed that the airways are a reservoir of previously unrecognized but clinically relevant organisms. Traditionally, antibiotic intervention in patients with CF presenting with acute bronchopulmonary exacerbations has been directed at a limited number of bacterial pathogens. In patients chronically colonized by conventional pathogens that demonstrate no bacteriological response to standard therapy, other antibiotics may have clinical efficacy. Using a case-based example, this review argues that pathogen-directed treatment based on inclusive quantitative microbiological protocols can result in improved patient outcomes. Furthermore, future therapeutic approaches that may rely on a polymicrobial perspective of the airways in CF are discussed.
Sibley
Christopher D
CD
Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada.
Parkins
Michael D
MD
Rabin
Harvey R
HR
Surette
Michael G
MG
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents