antibiotics

Question

Hello,

At the request of our CF-center, our 4 year old daughter is constantly on antibiotics all winter (alternating 15 days josamycin (macrolide) / cefpodoxim (cephalosporine) October to April), regardless of her state of health, particularly when "okay."

We have no doubt of the benefit of this procedure but we would like to understand a little better why antibiotics are used "preventive" in the context of cystic fibrosis. Have studies have reported a concrete benefit for the field of infections?

Also, what are the consequences of taking antibiotics over several months for the body of our daughter and future resistance to bacteria?
For example, we had to stop taking amoxicillin plus clavulanic acid, that she tolerated well taken occasionally before, because after a few weeks, severe gastrointestinal symptoms appeared (one treatment is the intake of saccharomyces cerevisiae which is also associated daily).

Thank you in advance for your response and we congratulate you for all the information available on the site.

Answer

Dear Madam and Sir,
Sequential alternating antibiotic are used quite frequently in children suffering fromc hronic bronchial diseases where the role of bacterial infection in the progression of the disease seems to be important. This can be the case in cystic fibrosis and other chronic bronchial diseases when child suffers repeated ly from bronchial superinfections. The concept (not scientifically validated) is based on maintaining an antibiotic "pressure" during a shorter or longer duration, reducing the bacterial load and the consequences of chronic infection and should improve symptoms that are directly related (the obstruction and bronchial hypersecretion). Even if no study to date scientifically validated this practice, its ancient and widespread use in many centers in France underlines its undeniable interest in terms of reducing acute respiratory symptoms (exacerbations) and improving the quality of life. It is true that the impact on flora has not been studied as such, but in practice it does not seem that the germs develop resistance to antibiotics. By cons, regardless of germs, some antibiotics may have side effects such as the one you bring for amoxicillin puls clavulanic acid. With my kind regards.
Dr Philippe Reix

14.03.2013