title: Recent advances in the treatment of Pseudomonas aeruginosa infections in cystic fibrosis.
abstract: Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients is caused by biofilm-growing mucoid strains. Biofilms can be prevented by early aggressive antibiotic prophylaxis or therapy, and they can be treated by chronic suppressive therapy. New results from one small trial suggest that addition of oral ciprofloxacin to inhaled tobramycin may reduce lung inflammation. Clinical trials with new formulations of old antibiotics for inhalation therapy (aztreonam lysine) against chronic P. aeruginosa infection improved patient-reported outcome, lung function, time to acute exacerbations and sputum density of P. aeruginosa. Other drugs such as quinolones are currently under investigation for inhalation therapy. A trial of the use of anti-Pseudomonas antibiotics for long-term prophylaxis showed no effect in patients who were not already infected. Use of azithromycin to treat CF patients without P. aeruginosa infection did not improve lung function. Here I review the recent advances in the treatment of P. aeruginosa lung infections with a focus on inhalation treatments targeted at prophylaxis and chronic suppressive therapy.
authors.affiliation: Department of Clinical Microbiology 9301, Rigshospitalet & ISIM, University of Copenhagen, Juliane Maries vej 22, DK-2100 Copenhagen, Denmark. hoiby@hoibyniels.dk
authors.forename: Niels
authors.initials: N
authors.lastname: Høiby
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003550:Cystic Fibrosis / Q000150:complications*; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents