title: Managing Pseudomonas aeruginosa respiratory infections in cystic fibrosis.
abstract: OBJECTIVE
  The current guidelines and recent clinical research in the management of Pseudomonas aeruginosa respiratory infections in cystic fibrosis (CF) are reviewed. Areas where further research is required will also be highlighted.
  
  
  RESULTS
  P. aeruginosa is a key respiratory pathogen in CF. Inhaled tobramycin or colistin is recommended for early eradication to prevent establishment of chronic infection. Other antibiotic options are currently being investigated. The long-term success of eradication strategies is also now being assessed. The use of inhaled antibiotics in the management of chronic P. aeruginosa infection is an area of active investigation. Acute pulmonary exacerbations are still a major cause of morbidity and mortality. Guidelines continue to recommend combination intravenous therapy but further research is required to clarify the advantage of this approach. Multidrug resistance is common and potentially more effective antipseudomonal antibiotics may soon become available.
  
  
  CONCLUSIONS
  The management of P. aeruginosa respiratory infection in CF remains a challenging area, especially in the setting of multidrug resistance. The role of inhaled antibiotics continues to be expanded. Further research is required in the key areas of eradication and management of chronic infection and acute pulmonary exacerbations to identify those treatments that optimize long-term, clinical benefits.
authors.affiliation: Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Langan
authors.forename: Tom
authors.initials: T
authors.lastname: Kotsimbos
authors.forename: Anton Y
authors.initials: AY
authors.lastname: Peleg
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D002939:Ciprofloxacin / Q000008:administration & dosage; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D025141:Drug Resistance, Fungal / Q000187:drug effects*; D006801:Humans; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D011550:Pseudomonas aeruginosa / Q000472:pathogenicity*; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014031:Tobramycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D014031:Tobramycin