Source: Annual Congress 2009 - Cystic fibrosis: advances in clinical research
Disease area: Paediatric lung diseases, Respiratory infections

Abstract

Introduction: Eradication of Pseudomonas aeruginosa (PA) and prevention of its chronic respiratory infection is considered an important surrogate marker of effectiveness of cystic fibrosis (CF) management.
Aim: We set out to audit management of PA infection in paediatric patients with CF in our institution against standards delineated in the United Kingdom CF trust consensus guidelines, 2002.
Results: Among 36 children with CF, 28 had had PA respiratory infection. We identified two patient groups with specific management issues. In the first group of 9 patients with a single or intermittent PA isolation, PA eradication was achieved through use of appropriate antibiotic treatment and microbiological surveillance following mean treatment duration of 3.5 months (Range, 3 - 5 months). In the second group of 19 patients with chronic PA infection, use of long term nebulised antipseudomonal antibiotic was discontinued in 3 patients. All three patients had stable CF lung disease and none had rising antipseudomonal antibody titres. Chronically infected patients with persistent respiratory isolation of PA received regular long term nebulised antibiotic treatment but none of them were treated with periodic elective intravenous antipseudomonal antibiotic courses.
Conclusion: In patients with chronic PA infection and stable CF lung disease, we suggest a pragmatic, individualised, and clinically guided approach to antibiotic use to ensure improved treatment compliance and better quality of life. This approach should be closely supervised by experienced CF clinician at a specialised CF unit with appropriate information and support to the patient and family.

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Citations should be made in the following way:
A. Chingale, C. Upton, A. Betteridge (Norwich, United Kingdom). Audit of management of pseudomonas aeruginosa infection in children with cystic fibrosis. Eur Respir J 2009; 34: Suppl. 53, 1259

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