Spanish Consensus on the Prevention and Treatment of Pseudomonas aeruginosa Bronchial Infections in Cystic Fibrosis Patients

Rafael Cantón, Luis Máiz, Amparo Escribano, Casilda Olveira, Antonio Oliver, Oscar Asensio, Silvia Gartner, Eva Roma, Esther Quintana-Gallego, Antonio Salcedo, Rosa Girón, María Isabel Barrio, María Dolores Pastor, Concepción Prados, María Teresa Martínez-Martínez, José Barberán, Juan José Castón, Luis Martínez-Martínez, José Luis Poveda, Carlos VázquezJavier de Gracia, Amparo Solé

Research output: Contribution to journalArticleResearchpeer-review

27 Citations (Scopus)

Abstract

© 2014 SEPAR Pseudomonas aeruginosa is the main pathogen in bronchopulmonary infections in cystic fibrosis (CF) patients. It can only be eradicated at early infection stages while reduction of its bacterial load is the therapeutic goal during chronic infection or exacerbations. Neonatal screening and pharmacokinetic/pharmacodynamic knowledge have modified the management of CF-patient. A culture based microbiological follow-up should be performed in patients with no infection with P. aeruginosa. At initial infection, inhaled colistin (0.5–2 MU/tid), tobramycin (300 mg/bid) or aztreonam (75 mg/tid) with or without oral ciprofloxacin (15–20 mg/kg/bid, 2–3 weeks) are recommended. In chronic infections, treatment is based on continuous administration of colistin or with a 28-day on–off regimen with tobramycin or aztreonam. During mild-moderate exacerbations oral ciprofloxacin (2–3 weeks) can be administered while serious exacerbations must be treated with intravenous combination therapy (beta-lactam with an aminoglycoside or a fluoroquinolone). Future studies will support rotation and/or new combination therapies. Epidemiological measures are also recommended to avoid new P. aeruginosa infections and cross transmission of this pathogen.
Original languageEnglish
Pages (from-to)140-150
JournalArchivos de Bronconeumologia
Volume51
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015

Keywords

  • Antibiotic treatment
  • Bronchial infection
  • Cystic fibrosis
  • Pseudomonas aeruginosa

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