Article Text

  1. S Fustik1,
  2. T Jakovska1,
  3. L Spirevska1
  1. 1University Pediatric Clinic, Skopje, Macedonia


Objective Chronic pulmonary infection with Pseudomonas aeruginosa PA is responsible for most of the morbidity and mortality in cystic fibrosis CF. In 2000, we introduced an eradication regime at time of initial or intermittent PA isolation consisting of inhaled colistin or gentamycin and oral ciprofloxacin for 6weeks. If unsuccessful, a course of intravenous antiPA antibiotics for 2weeks was advised.

Methods The aim of the study was to evaluate the efficacy of the PA eradication regimen by microbiological studies of oropharyngeal swab samples andor precipitating antibodies against PA in serum samples. Chronic PA infection was defined as persistent presence of PA for at least 6 consecutive months andor presence of two or more PA precipitants. Intermittent PA colonization was defined as a culture of PA at least once and presence of normal levels of precipitating antibodies against PA 01.

Results During the study period from 2000 to 2006, eradication therapy was performed in 39 range 15 CF patients. Six of the treated patients 15.6 developed chronic PA infection. Chronic PA infection was already established in 3 patents when they first attended the clinic and in 2 patients who were lost at followup for longer periods. In contrast, in the period from 1994 to 2000, only 4 out of 21 intermittently colonized CF patients remained free of PA.

Conclusions Regular patients controls and early eradication therapy can effectively delay acquisition of chronic PA infection in a considerable proportion 84.4 of patients with CF and decrease disease progression.

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