Airways infection in CF patients, once established, is rarely if ever eradicated. Nevertheless, it was suggested that early and aggressive antibiotic treatment at first positive isolate can delay chronic colonization by P. aeruginosa. In order to assess whether antibiotic treatment at first Bc-positive sputum culture could be effective in avoiding or delaying chronic colonization, we retrospectively evaluated the persistence of Bc in the sputum of 54 CF patients. 40/54 patients received antibiotic treatment at the time of the first Bc-positive isolate: antibiotic therapy was started when sputum culture was in course and the indication to treatment was based on clinical findings (not aimed at Bc eradication). When antibiotic therapy was effective in vitro against Bc, we retrospectively considered the patient as "specifically" treated. Of the specifically treated patients, 18 where thereafter found to be chronically colonized; another 16/40 had Bc-negative sputum cultures (8/16 became later chronically colonized after an average period of 2,9 yr). Another 6/40 patients showed intermittently positive sputum culture (average follow-up 2,5 yr). Of the 14 non-specifically treated patients, 7 thereafter turned out to be chronically colonized and 7 where negative (3/7 became later chronically colonized after an average period of 3 yr). In our data, antibiotic treatment did not affect the outcome with respect to persistence of Bc in the sputum. This is true also when data are considered separately according to the mode of antibiotic administration (oral/inhaled or parenteral). Our data can not be considered conclusive, but, at the same time, do not encourage prospective studies, unless combined with anti-Bc specific antibodies assessment and with more aggressive antibiotic treatment (e.g. association of three or more antibiotics) in consideration of the prompt development of resistance showed by Bc.
|Issue number||4 SUPPL.|
|Publication status||Published - Oct 1996|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine