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Complementary drugs for pseudomonas

Hi, my daughter is 7 years old and since the beginning of the year we are fighting against Pseudomonas. Actually we are for the second time for iv antibiotics in hospital. My question is, are there any additional options in complementary medicine? Is there any experience in treatment with Manuka honey, curcuma, cysticus…or what else helps?? Is there anything you can recommend in addition to drug therapy? Thank you for your comments.
Dear Questioner,
thank you for your request.
Here is what we know how the effect of curcumin in CF is generated: In CF there is a salt channel that does not work well. The idea is, that curcumin stimulates this channel to a gain of function. Unfortunately, there is too little data to provide evidence that this is also true in CF patients or what we call a clinical effect. So there are doubts if this is a successful treatment option.

The same is true concerning garlic and ginseng.

Concerning Manuka honey there is one study from 2015 from the microbiology lab. They were able to show that the growth of bacteria like P.aeruginosa and B.cepacia on culture plates is inhibited by Manunka honey. There are no studies with Manuka honey in CF patients so far available.

Probiotics improve the gut flora. In Germany Mutaflor® is a probiotic, that is reimbursed by the healthcare system, if the patient reveiced antibiotics. There is a link between the mucosal immune system in the gut and the airways. Unfortunately, there is also insufficient data for a clear recommendation to give probiotics. If there is no history of immune deficiency and your child is not on an immunosuppressive therapy (e.g. systemic steroids), there should be no harm by using probiotics.

It is important, that your body’s immune system works on an optimal level. To achieve this goal, a sufficient vitamin D level is necessary. Has this been checked lately in your child? It is often necessary to supplement vitamin D (by tablets). In addition, it is important to supply sufficient amounts of zinc. Regular controls of vitamin A and E level (via blood) are recommended resp. should be supplemented eventually. (The drug AquADEK contains Vitamin A, D, E and zinc).

We also see often in children with CF a lack of trace elements like selen. Selen as well is important to fight inflammation. We found its supplementation helpful in our patients. But there are no studies to provide sufficient evidence.

Nutritional status is also important for the body’s immune system. The ratio of body weight to length is important. Its measure is the so called body mass index (BMI). What is the BMI percentile of your kid? If it is too low, nutritional supplements (e.g. Frebini® in Germany) should be considered. Moreover a food protocol (over a week) taken annually and the respective dietary consultation by a dietary specialist are helpful. One of the goals is to check for optimizing dietary supply of vitamins and trace elements (probably this was already done or is on schedule for your child).

To get ride of Pseudomonas aeruginosa in the lung, the therapy regimen of Prof. Riethmüller (University Children’s Hospital Tübingen, Germany) should be considered: Their scheme is inhalation of tobramycin and colistine in parallel in the same therapy cycle. Moreover continuation of inhalation of nebulized antibiotics in addition to iv antibiotics can be considered: There is data to provide evidence that nebulized antibiotics reach parts of the lung where iv antibiotics do not go. Daily physiotherapy and drugs that liquify the sticky secretions are of utmost importance to clarify the lung from sputum. These sticky secretions may obstruct the airways. In terms of secretolytics is your child on daily inhalations with pulmozyme in combination with physiotherapy?

I hope this might help you. Talk to your CF-Center/Physician about these options.

Best regards,
PD Dr. Sabina Schmitt-Grohé