Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis

S.L. Kenny; T. D. Shaw; D. G. Downey; J. E. Moore; J. C. Rendall; J. S. Elborn

doi:10.1136/bmjresp-2014-000021

Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis

S.L. Kenny, T. D. Shaw^*, D. G. Downey, J. E. Moore, J. C. Rendall, J. S. Elborn

^*Corresponding author for this work

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Abstract

Background

Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8–93.0%. In this retrospective cohort study, we report the outcomes of AET in an adult population.

Methods

Adults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012. Choice of therapy, time to eradication and reinfection, and lung function (forced expiratory volume in 1 s (FEV1)) were determined.

Results

20 patients (median age 27 years) isolated P aeruginosa during the study period. 10 patients were treated with oral ciprofloxacin (median duration 6 weeks) and nebulised colomycin (median duration 3 months). 7 patients were treated with intravenous antipseudomonal antibiotics (median duration 14 days). 2 patients received other combinations of oral and inhaled antipseudomonal therapy and one patient received no therapy. AET was successful in 15 cases who received antipseudomonal therapy (79%). The median time to eradication was 1 month. The median time to reinfection with P aeruginosa was 43 months. There was no significant change in FEV1 after 12 months.

Conclusions

Aggressive AET of new infection of P aeruginosa in adults is successful in the majority of patients and has similar efficacy to the reported efficacy in paediatric populations.

Original language	English
Article number	e000021
Pages (from-to)	1-7
Journal	BMJ Open Respiratory Research
Volume	1
Early online date	25 Apr 2014
DOIs	https://doi.org/10.1136/bmjresp-2014-000021
Publication status	Published - Aug 2014

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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10.1136/bmjresp-2014-000021Licence: CC BY-NC

Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis
Copyright 2014 the authors. This is an open access article published under a Creative Commons Attribution-NoDerivs License (https://creativecommons.org/licenses/by-nd/4.0/), which permits reproduction and redistribute in any medium, provided the author and source are cited and any subsequent modifications are not distributed.
Final published version, 999 KBLicence: CC BY-NC

Cite this

@article{2a57dcbc8f4540eb8c98eda45fff57f2,

title = "Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis",

abstract = "Background Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8–93.0\%. In this retrospective cohort study, we report the outcomes of AET in an adult population.MethodsAdults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012. Choice of therapy, time to eradication and reinfection, and lung function (forced expiratory volume in 1 s (FEV1)) were determined. Results 20 patients (median age 27 years) isolated P aeruginosa during the study period. 10 patients were treated with oral ciprofloxacin (median duration 6 weeks) and nebulised colomycin (median duration 3 months). 7 patients were treated with intravenous antipseudomonal antibiotics (median duration 14 days). 2 patients received other combinations of oral and inhaled antipseudomonal therapy and one patient received no therapy. AET was successful in 15 cases who received antipseudomonal therapy (79\%). The median time to eradication was 1 month. The median time to reinfection with P aeruginosa was 43 months. There was no significant change in FEV1 after 12 months. Conclusions Aggressive AET of new infection of P aeruginosa in adults is successful in the majority of patients and has similar efficacy to the reported efficacy in paediatric populations.",

author = "S.L. Kenny and Shaw, \{T. D.\} and Downey, \{D. G.\} and Moore, \{J. E.\} and Rendall, \{J. C.\} and Elborn, \{J. S.\}",

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journal = "BMJ Open Respiratory Research",

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AU - Kenny, S.L.

AU - Shaw, T. D.

AU - Downey, D. G.

AU - Moore, J. E.

AU - Rendall, J. C.

AU - Elborn, J. S.

PY - 2014/8

Y1 - 2014/8

N2 - Background Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8–93.0%. In this retrospective cohort study, we report the outcomes of AET in an adult population.MethodsAdults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012. Choice of therapy, time to eradication and reinfection, and lung function (forced expiratory volume in 1 s (FEV1)) were determined. Results 20 patients (median age 27 years) isolated P aeruginosa during the study period. 10 patients were treated with oral ciprofloxacin (median duration 6 weeks) and nebulised colomycin (median duration 3 months). 7 patients were treated with intravenous antipseudomonal antibiotics (median duration 14 days). 2 patients received other combinations of oral and inhaled antipseudomonal therapy and one patient received no therapy. AET was successful in 15 cases who received antipseudomonal therapy (79%). The median time to eradication was 1 month. The median time to reinfection with P aeruginosa was 43 months. There was no significant change in FEV1 after 12 months. Conclusions Aggressive AET of new infection of P aeruginosa in adults is successful in the majority of patients and has similar efficacy to the reported efficacy in paediatric populations.

AB - Background Eradication of new infection of Pseudomonas aeruginosa is an important intervention in managing cystic fibrosis (CF). Previous trials, studying predominantly under 18-year-olds, indicate that antibiotic eradication therapy (AET) has success rates of 62.8–93.0%. In this retrospective cohort study, we report the outcomes of AET in an adult population.MethodsAdults with a confirmed diagnosis of CF and a first isolation of P aeruginosa were studied between 1999 and 2012. Choice of therapy, time to eradication and reinfection, and lung function (forced expiratory volume in 1 s (FEV1)) were determined. Results 20 patients (median age 27 years) isolated P aeruginosa during the study period. 10 patients were treated with oral ciprofloxacin (median duration 6 weeks) and nebulised colomycin (median duration 3 months). 7 patients were treated with intravenous antipseudomonal antibiotics (median duration 14 days). 2 patients received other combinations of oral and inhaled antipseudomonal therapy and one patient received no therapy. AET was successful in 15 cases who received antipseudomonal therapy (79%). The median time to eradication was 1 month. The median time to reinfection with P aeruginosa was 43 months. There was no significant change in FEV1 after 12 months. Conclusions Aggressive AET of new infection of P aeruginosa in adults is successful in the majority of patients and has similar efficacy to the reported efficacy in paediatric populations.

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Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis

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Investigating the antimicrobial efficacy of mesenchymal stromal cells as a novel potential therapy for Mycobacterium avium pulmonary infection

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Eradication of Pseudomonas aeruginosa in adults with cystic fibrosis

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Investigating the antimicrobial efficacy of mesenchymal stromal cells as a novel potential therapy for Mycobacterium avium pulmonary infection

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