6533b85afe1ef96bd12b8dd7
RESEARCH PRODUCT
Spanish Consensus on the Prevention and Treatment of Pseudomonas aeruginosa Bronchial Infections in Cystic Fibrosis Patients
Antonio OliverConcepción PradosAmparó SoléOscar AsensioMaría Martínez-martínezEsther Quintana-gallegoLuis MáizJavier De GraciaJosé Luis PovedaCarlos VázquezLuis Martínez-martínezRafael CantónJosé BarberánRosa GirónMaría Dolores PastorAntonio SalcedoCasilda OlveiraJuan José CastónAmparo EscribanoSilvia GartnerMaría Isabel BarrioEva Romásubject
medicine.medical_specialtyCystic Fibrosismedicine.drug_classAntibioticsAztreonammedicine.disease_causeCystic fibrosisCystic fibrosischemistry.chemical_compoundInternal medicinemedicineTobramycinHumansPseudomonas InfectionsIntensive care medicinebusiness.industryPseudomonas aeruginosaGeneral Medicinemedicine.diseaseAntibiotic treatmentAnti-Bacterial AgentsCiprofloxacinChronic infectionchemistryChronic DiseasePseudomonas aeruginosaDisease ProgressionColistinbusinessBronchial infectionmedicine.drugdescription
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. (C) 2014 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.
year | journal | country | edition | language |
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2014-04-05 | Archivos de Bronconeumología (English Edition) |