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

作者：Canton Rafael^*; Maiz Luis; Escribano Amparo; Olveira Casilda; Oliver Antonio; Asensio Oscar; Gartner Silvia; Roma Eva; Quintana Gallego Esther; Salcedo Antonio; Giron Rosa; Isabel Barrio Maria; Dolores Pastor Maria; Prados Concepcion; Teresa Martinez Martinez Maria; Barberan Jose; Jose Caston Juan; Martinez Martinez Luis; Luis Poveda Jose; Vazquez Carlos; de Gracia Javier; Sole Amparo

来源：Archivos de Bronconeumologia, 2015, 51(3): 140-150.

DOI：10.1016/j.arbres.2014.09.021

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

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 has modified the management of CF-patients. 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 antibiotic rotation and/or new combination therapies. Epidemiological measures are also recommended to avoid new P. aeruginosa infections and "patient-to-patient transmission" of this pathogen.

• 出版日期2015-3