Prevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment

doi:10.1016/0140-6736(91)91446-2

The Lancet

Volume 338, Issue 8769, 21 September 1991, Pages 725-726

https://doi.org/10.1016/0140-6736(91)91446-2 Get rights and content

Abstract

To assess whether chronic pulmonary colonisation with Pseudomonas aeruginosa in cystic fibrosis is preventable, 26 patients who had never received anti-pseudomonas chemotherapy were randomly allocated to groups receiving either no anti-pseudomonas chemotherapy or oral ciprofloxacin and aerosol inhalations of colistin twice daily for 3 weeks, whenever Ps aeruginosa was isolated from routine sputum cultures. During the 27 months of the trial, infection with Ps aeruginosa became chronic in significantly fewer treated than untreated subjects (2 [14%] vs 7 [58%]; p<0·05) and there were significantly fewer Ps aeruginosa isolates in routine sputum cultures in the treated group (49/214 [23%] vs 64/158 [41%]; p=0·0006). Thus, chronic colonisation with Ps aeruginosa can be prevented in cystic fibrosis by early institution of anti-pseudomonas chemotherapy.

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Citation Excerpt :
Table 1 describes the different definitions used for first lifetime or positive Pa culture after a stated time scale in studies aiming for Pa eradication. This includes first lifetime documented culture positive for Pa [17–20] or positive Pa culture following a negative Pa timescale for: 6 months [21–23], 1 year [24–29] and 2 years [30–32]. Other differences among the studies included the type/combination of samples collected sputum versus oropharyngeal (OP) swabs versus BAL [21,23,25,33–37] versus laryngeal suction [28,38].
Definition of Pseudomonas aeruginosa (Pa) microbiological status is essential for patients' inclusion in clinical trials. The aim of this study was to agree on the definitions of Pa infection status for initial infection, eradication and chronic infection to be used in clinical trials and to propose additional future study areas.
An exhaustive literature search was performed. The clinimetric properties of different definitions of Pa microbiological status were evaluated.
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Chronic Pa infection was characterized by high levels of antibodies and good concordance between culture results and serology.
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SHORT REPORTSPrevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment

Abstract

Lancet

Chest

Chest

Frequent antibiotic therapy improves survival of cystic fibrosis patients with chronic Pseudomonas aeruginosa infection

Acta Paediatr Scand

SHORT REPORTS
Prevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment