Cough

Question

My daughter, 9 years old, has CF and we have often exacerbations. When on antibiotics we are OK, but after 2-3 weeks bad cough usually begins. Only Cefuroxim is effective as oral antibiotic. How long can antibiotics be used and are there other similar antibiotics?

Answer

Dear Questioner,
Children with CF usually have a persisting cough with secretions.
In a CF child, often airway infections are bacterial. Frequent and often long standing antibiotic treatments are the cornerstone in CF treatment. Many studies demonstrate that CF patients do better in the long run if more frequently treated with antibiotics. Choice of antibiotics, duration of treatment and other questions should be discussed with CF specialist.

However, even if long-term antbiotic treatment is necessary, it can also lead to increasing resistance of bacteria if the therapy is not targeted (e.g. it has been shown that continous anti-staphylococcal therapy was associated with a higher rate of P. aerouginosa, in half of the cases patients were under cepahlosporine (Cefuroxim is a cephalosporine) therapy. Therefore, especially in your case where the cough begins just 2-3 weeks after ending of the antibiotic therapy, one should have a close look on the bacteria which are found in your daughters specimens. That means: before initializing an antibiotic therapy it is necessary to culture the germ out of the sputum and to do a testing of the antibiotic resistance in order to find the right and most effective antibiotic drug.

Regards,
Sigitas Dumcius

20.11.2008