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Treatment of Pseudomonas-colonization
- Question
- Hello,
I am 20 years old, male, CF, until now mild course of the disease. Besides Staphyloccus aureus, now Pseudmonas-germ has been found. How are the actual options of treatment? Is one now all the time susceptible to Pseudomonas, in case the germ can be eradicated with antibiotic-therapy and Tobramycin? Lung function is normal.
Many thanks for your answer,
Best regards, - Answer
- Hello, dear questioner,
Pseudomonas aeruginosa (PA) occurs in over 80% of all adult CF patients in the airways. After the first detection, always a trial of eradication (trial to get rid of the germ from the airways durably) should be undertaken. In most cases, only a temporary eradication is possible, so that after some time the germ occurs again in the bronchi. In spite of this, in every case of a confirmed new detection, a therapy should be initiated. It is recommended to initiate such a treatment soon after the detection of PA. Furthermore, a measurement of the PA-antibodies in the blood is advisable. In case of a new-detection of PA there are several ways of therapy, dependent on the general health state and the overall situation:
- one possibility is the usage of an inhalative antibiotic therapy with e.g. Tobramycin (preparations Tobi®, Bramitob®), or with Colomycin (preparations: Colistin®, Promyxin®)
- a second possibility is a 2-week intra-venous PA-effective antibiotic therapy with a combination of antibiotics, in most cases with 2 antibiotics
- another therapeutic option is the performance of an eradication therapy according to the denish recommendations (Prof. Hoiby) as a combination of 2 PA-effective antibiotics, the oral antibiotic Ciprofloxacin (in the form of tablets) plus inhalative Colomycin as second antibiotic.
As you can see there isn't just one way of doing it. It is important, that one finds the best one in your case, that means the one that has most chances of success for you. Which way would be the best for you and as well as the practical performance of the therapy, you should discuss with your CF-doctors in charge.
Yours sincerely,
Dr. Christina Smazcny - 04.10.2010
