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Question

My wife is CF patient

We have recently heard that she is becoming resistant for several antibiotics. At the moment there are two kinds of antibiotics left. The bacteria that is causing most problems is the E coli bacteria. My question is whether there is a risk that my wife will become resistant for the last two antibiotics in relation to this specific E coli bacteria.

Answer

Dear sir,

Thank you for your question. Within ECORN we are not able to reply specifically on questions relating to one patient, like your wife. We will answer your question on CF and antibiotics resistance more generally.
Often, with increasing age and/or after repeated intensive antibiotics treatment resistance against antibiotics will occur. There is no reason for immediate despair. This problem has been studied extensively and it is found that even with resistance for certain antibiotics, a treatment with antibiotics, mostly through combining different kinds of antibiotic will be effective.

An interesting study has been conducted on this problem. In this study antibiotics-combinations were investigated in the laboratory for individual patients. At a next exacerbation these patients were treated with the best antibiotics combination that was assess in the laboratory OR the combination that was chosen by the doctor based on routine information available in the files about the patient. There was no difference between the two treatments.

How can we interpret these data? This study proves partly that the present techniques of studying the resistance for antibiotics in the laboratory does not mirror the way the bacteria ‘behaves’ in the lung or how the antibiotic works in the lung.

Of course this is a general answer. For a specific answer to your question concerning you wife we advise you to contact het CF specialist.

Best wishes,
K. De Boeck

04.10.2010