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Antibiotics without symptoms

Dear expert team,
my son (a few months old, CF) has had a throat swab with the finding of Staphylcoccus aureus. For which reason the intake of antibiotics are necessary if he hasn't any symptoms at all like cough, secretions etc. respectively which consequences would it have if one would not give an antibiotic and wait, until symptoms occur?
Best regards,
Dear questioner,
in general it has to be said, that in case of most CF patients Staphylcoccus aureus is found as the first germ when doing routine investigations. Only later, other germs play a greater role. The finding of a germ in a throat swab of a baby has also to be regarded critically. It has to be questioned, if it was a single finding or if the germ has been found in a row of controls in a short time interval. A single finding does not mean that the lung is colonized. We know from routinely done studies with bronchoscopies and the gained bronchial secretions that in case of symptom-free babies without cough or increased secretions there are nonetheless inflammatory processes in the lung.
For a long time already, there exist different judgments of CF physicians concerning the situation of your son. On the one hand there are physicians, who recommend an antibiotic therapy independent of the symptoms and the laboratory findings. The other group of physicians recommends a symptom-orientated therapy. Among this group, there are a few collegues, who recommend to see the patient every month in the CF center, in order to have a very close eye on the development of the CF patient.
As for many patients, a colonization of the lung with Staph. aureus means a permanent colonization, one has also to ask the question, if a long-term antibiotic therapy would be acceptable. One knows about such a long-term therapy, that it could enhance the rate of early colonization of the lung with Pseudomonas aeruginosa. Until now, there are no studies with a satisfying number of patients comparing the group of routinely treated versus the group of symptom-based treated patients, that could show an advantage of one group.
For your son this means, that you should discuss the situation in detail with your treating physicians in order to come to an acceptable solution for both sides.
Best regards,
Dr. H.-G. Posselt