Another question on antibodies

Question

[These question refers to the question "antibodies"]

Dear Dr. Hügel!
Referring to your answer on the question "antibodies" I have another question:
if respective antibodies against Pseudomonas can be detected and however no Pseudomonas can be found with the usual investigation methods (throat swab, sputum, induced sputum) - would an anti-Pseudomonas therapy (e.g. an oral or inhalative treatment) be initiated in spite of this according to the guidelines?
An the second question would be: can antibodies be investigated for any germ and probably can one conclude from the amount of the antibodies which germ plays the first role respecitvely causes the problems?
In advance many thanks for your answer
I.D.

Answer

Hello,
in the sense of the current guildelines, your question is addressed in the S-3 guideline "lung disease in CF, diagnostics and therapy after the first detection of Pseudomonas aeruginosa" [German guideline]. There is says, that for a patient without the finding of Pseudomonas aerugiosa in the airway secretions however with a positive finding of antibodies and an exacerbation, an antibiotic treatment is recommended.
In case of the finding of antibodies without a clinical worsening, addional diagnostic measures should be done if needed. In case of the finding of Pseudomonas with this additional diagnostic measures, an antibioitc treatment is recommended. If Pseudomonas cannot be found, ongoing controls are recommended.

Other measurements of antibodies against other germs are not in use in the daily clinical practice at the moment.
As the expert team of ECORN-CF has an advisory function, I recommend to address your questions also to your CF center team, as a clinical decision can vary in the single case.

Best regards,
Dr. Christian Hügel

25.01.2016