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. 2014 Apr 23;1(1):e000021.
doi: 10.1136/bmjresp-2014-000021. eCollection 2014.

Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis

S L Kenny  1 , T D Shaw  1 , D G Downey  2 , J E Moore  3 , J C Rendall  2 , J S Elborn  4
Affiliations

Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis

S L Kenny et al. BMJ Open Respir Res. .

Abstract

Background: Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8-93.0%. In this retrospective cohort study, we report the outcomes of AET in an adult population.

Methods: Adults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012. Choice of therapy, time to eradication and reinfection, and lung function (forced expiratory volume in 1 s (FEV1)) were determined.

Results: 20 patients (median age 27 years) isolated P aeruginosa during the study period. 10 patients were treated with oral ciprofloxacin (median duration 6 weeks) and nebulised colomycin (median duration 3 months). 7 patients were treated with intravenous antipseudomonal antibiotics (median duration 14 days). 2 patients received other combinations of oral and inhaled antipseudomonal therapy and one patient received no therapy. AET was successful in 15 cases who received antipseudomonal therapy (79%). The median time to eradication was 1 month. The median time to reinfection with P aeruginosa was 43 months. There was no significant change in FEV1 after 12 months.

Conclusions: Aggressive AET of new infection of P aeruginosa in adults is successful in the majority of patients and has similar efficacy to the reported efficacy in paediatric populations.

Keywords: Bacterial Infection; Cystic Fibrosis; Respiratory Infection.

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Figures

Figure 1
Figure 1
Comparison breakdown of genetic mutations between the study patients and all adult patients with cystic fibrosis on the registry.
Figure 2
Figure 2
Chart showing outcomes of antipseudomonal therapy of study population. CF, cystic fibrosis; NI, Northern Ireland.
See this image and copyright information in PMC

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