Antimicrobial therapy for pulmonary pathogenic colonisation and infection by Pseudomonas aeruginosa in cystic fibrosis patients

摘要: Pseudomonas aeruginosacolonisation has a negative effect on pulmonary function in cysticfibrosis patients. The organism can only be eradicated the early stage of colonisation, while reduction bacterial density is desirable during chronic colonisation or exacerbations. Monthly, at least 3-monthly, microbiological cultureisadvisableforpatientswithoutpreviousevidenceof P. aeruginosacolonisation.Culturesshouldbe performed every 2‐3 months patients with well-established and always exacerbations hospitalisations. Treatment following first isolation aeruginosa, but no clinical signs should oral ciprofloxacin (15‐20 mg ⁄kg twice-daily for 3‐4 weeks) plus inhaled tobramycin colistin (intravenous treatment without canbeusedasanalternative),whilepatientswithacuteinfectionshouldbetreatedfor14‐21dayswithhigh dosesoftwointravenousantimicrobialagents,withorwithoutaninhaledtreatmentduringorattheendof intravenous treatment. Maintenance after development aeruginosa infection ⁄colonisation (pathogenic colonisation) stable (aged > 6 years) (300 twice-daily) 28-day cycles (on‐off) or, as an alternative, (1‐3 million units twice-daily).Colistinisalsoapossiblechoiceforpatientsaged<6 years.Treatmentcanbecompletedwith (3‐4 weeks months) mild symptoms, intravenously(every3‐4 months)forthosewithseveresymptomsorisolateswithciprofloxacinresistance. Moderate serious treated ceftazidime (50‐70 threetimes-daily) cefepime (50 three-times-daily) (5‐10 24 h) amikacin (20‐30 weeks. Oral recommended disease. If multiresistant isolated, antimicrobial agents that retain activity are epidemiological control measures established.