PSEUDOMONAS INFECTIONS IN CYSTIC-FIBROSIS - MICROBIOLOGICAL ASPECTS AND ANTIMICROBIAL THERAPY

Lung infection with P. aeruginosa and Burkholderia cepacia is associat ed with a greater morbidity and mortality in cystic fibrosis. Over 90 % of the patients will suffer from chronic endobronchial infections wi th P. aeruginosa and once established, it is seldom eradicated despite intravenous antibiotic therapy. Slow growth phase, bacterial biofilms and alginate of P. aeruginosa, macromolecular binding, and the ionic environment of sputum contribute to reducing antibacterial activity of antibiotics. However, the use of regular antipseudomonas therapy, for two week periods, every 3-4 months, regardless of acute exacerbation has significantly improved the prognosis and reduced the mortality rat e. Long-term antibiotic inhalation therapy combined with oral ciproflo xacin during these intervals increase bacterial eradication.