EFFECT OF ANTIBIOTIC-TREATMENT ON INFLAMMATORY MARKERS AND LUNG-FUNCTION IN CYSTIC-FIBROSIS PATIENTS WITH PSEUDOMONAS-CEPACIA

Background - The acquisition of Pseudomonas cepacia in patients with c ystic fibrosis is associated with increasing deterioration in lung fun ction and more frequent hospital admissions. Pseudomonas cepacia is us ually resistant to several antibiotics in vitro, but the response of p atients colonised with the organism has not been extensively studied i n vivo. Methods - A three month prospective study was performed to inv estigate the response of 14 Ps cepacia positive patients and 10 Ps cep acia negative patients to a two week course of intravenous antibiotics . All those who were Ps cepacia negative and six of the 14 Ps cepacia positive patients had Ps aeruginosa in their sputum which was sensitiv e to the prescribed therapy. The inflammatory markers C-reactive prote in, white blood cell count, serum lactoferrin, neutrophil elastase/alp ha(1)-antitrypsin complex, and tumour necrosis factor alpha were measu red at the start and end of each antibiotic course. Results - The medi an (range) % improvement in baseline FEV(1) and FVC following treatmen t in the group as a whole was 15.2% (-23.5% to 156.3%) and 23.9% (-36. 8% to 232.7%) respectively. There was no statistical difference in imp rovement in lung function, body weight, or inflammatory markers betwee n individuals who were Ps cepacia positive and those who were Ps cepac ia negative. Conclusions - Patients who are Ps cepacia positive appear to respond as well to intravenous antibiotics as those who are Ps cep acia negative, despite having lower lung function and a bacterium in t heir sputum which is resistant in vitro to the antibiotics used.