title: Clearance of initial mucoid Pseudomonas aeruginosa in patients with cystic fibrosis.
abstract: BACKGROUND
  Accelerated lung function decline in cystic fibrosis (CF) is associated with mucoid Pseudomonas aeruginosa infection. Recent data suggest that mucoid P. aeruginosa may amenable to elimination from the airway. We aim to determine whether the initiation of an aggressive antibiotic eradication regimen upon initial discovery of mucoid P. aeruginosa in the CF airway could be successful in clearing the organism from the CF lung.
  
  
  METHODS
  We performed a retrospective analysis of patients with CF who demonstrated new growth of mucoid P. aeruginosa in an airway culture between January 2003 and December 2008. The primary endpoint was clearance of mucoid P. aeruginosa, based upon the Leeds criteria, with no further growth of mucoid P. aeruginosa cultures within 12 months of the initial discovery and treatment. Factors associated with successful clearance were also evaluated.
  
  
  RESULTS
  Forty-eight of 355 patients with CF had a new diagnosis of mucoid P. aeruginosa during the study period; 15 patients underwent an eradication attempt, while 33 patients received no increase in therapy. We observed clearance of mucoid P. aeruginosa in 73.3% of patients undergoing an eradication attempt, whereas 36.6% of those that did not undergo attempted eradication cleared the organism at 1 year (P < 0.05). Prolonged mucoid P. aeruginosa airway clearance (>24 months) for mucoid P. aeruginosa was seen in 60.0% in subjects undergoing eradication compared to 21.2% (P = 0.02) in control patients. At the study conclusion, lung function was greater in subjects who underwent an eradication attempt than in patients who did not undergo an eradication attempt (FEV(1) %: 91.7% vs. 75.0%, P = 0.04).
  
  
  CONCLUSIONS
  Clearance of initial mucoid P. aeruginosa from the airways of select patients with CF is possible with current antibiotic regimens, and the attempt may be associated with improved lung function.
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. btroxler@peds.uab.edu
authors.forename: Robert Bradley
authors.initials: RB
authors.lastname: Troxler
authors.forename: Wynton C
authors.initials: WC
authors.lastname: Hoover
authors.forename: LaCrecia J
authors.initials: LJ
authors.lastname: Britton
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Gerwin
authors.forename: Steven M
authors.initials: SM
authors.lastname: Rowe
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000502:physiology; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000503:physiopathology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D012008:Recurrence; D012129:Respiratory Function Tests; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents