Antibiotics therapy (over three months) necessary?

Question

Dear expert team,

My daughter (CF patient, three years old, mild progression so far with only a few minor infections, completely without cough for three years except during infection times) was just diagnosed with an acute infection of the lungs with Staph. aureus (anti-staphylolysin positive). Recently she had bronchitis for the first time for about four weeks and since then has been having nervous cough every once in a while during days and nights. Apart from this, she is currently infection-free.

The CF clinic suggested a three-month antibiotics therapy in order to decrease the antibodies again and possibly eliminate the Staph. aureus. What do you think about this? Do you consider the therapy reasonable?

Many thanks for your answer.

Answer

Hello,

You are asking whether it is reasonable to have your three-year-old daughter undergo a three-month antibiotics therapy. Your daughter, who has only had a few minor infections so far, currently has been having nervous cough during days and nights for four weeks. A recent throat swab only showed Staph. aureus.

It is known that younger children with CF often suffer from a long-term colonization of the lungs with Staph. aureus. This persistent colonization can take the same course as a Pseudomonas aeruginosa colonization, i.e. the germ cannot be eliminated despite repeated systematic treatment with antibiotics. Since your daughter currently has a lasting tussive irritation even at night, such a treatment approach over three months can make sense. One cannot predict whether this will eliminate the germ. However, the most important thing is that the nervous cough stops and that your daughter will be symptom-free again.

All the best to you and your daughter.

Kind regards,
Dr. H.-G. Posselt

01.12.2011