Antibiotic therapy in cystic fibrosis

Antibiotherapy is one of the main treatments of cystic fibrosis, contributi ng to a better nutritional and respiratory status and a prolonged survival. The choice of antibiotics depends on quantitative and qualitative analysis of sputum, bacteria resistance phenotypes and severity of infection. Haemo philus influenzae infection can be treated orally with the association of a moxicillin-clavulanic acid or a cephalosporin. Staphylococcus aureus genera lly remains sensitive to usual antibiotics, in case of a methicillin-resist ant strain, an oral bitherapy or a parenteral cure can be proposed. Treatme nt of Pseudomonas aeruginosa is different in case of first colonization or chronic infection: in first colonization, parenteral antibiotherapy (beta-l actams-aminoglycosids) followed by inhaled antibiotherapy may eradicate the bacteria; in chronic infections, exacerbations require parenteral bi-antib iotherapy (beta-lactams or quinolons and aminoglycosids) for 15 to 21 days, inhaled antibiotics between the cures being useful to decrease the number of exacerbation. A careful monitoring of antibiotherapy is necessary becaus e of possible induction of bacterial resistance, nephrotoxicity and ototoxi city of aminosids and allergy to beta-lactams. (C) 2000 Editions scientifiq ues ef medicales Elsevier SAS.