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The Scientific World Journal
Volume 2013, Article ID 645653, 13 pages
http://dx.doi.org/10.1155/2013/645653
Review Article

Treatment of Pseudomonas and Staphylococcus Bronchopulmonary Infection in Patients with Cystic Fibrosis

1Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019, India
2Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
3Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India

Received 9 August 2013; Accepted 2 October 2013

Academic Editors: A. Sihoe and F. Varoli

Copyright © 2013 Rashmi Ranjan Das et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The optimal antibiotic regimen is unclear in management of pulmonary infections due to pseudomonas and staphylococcus in cystic fibrosis (CF). We systematically searched all the published literature that has considered the evidence for antimicrobial therapies in CF till June 2013. The key findings were as follows: inhaled antipseudomonal antibiotic improves lung function, and probably the safest/most effective therapy; antistaphylococcal antibiotic prophylaxis increases the risk of acquiring P. aeruginosa; azithromycin significantly improves respiratory function after 6 months of treatment; a 28-day treatment with aztreonam or tobramycin significantly improves respiratory symptoms and pulmonary function; aztreonam lysine might be superior to tobramycin inhaled solution in chronic P. aeruginosa infection; oral ciprofloxacin does not produce additional benefit in those with chronic persistent pseudomonas infection but may have a role in early or first infection. As it is difficult to establish a firm recommendation based on the available evidence, the following factors must be considered for the choice of treatment for each patient: antibiotic related (e.g., safety and efficacy and ease of administration/delivery) and patient related (e.g., age, clinical status, prior use of antibiotics, coinfection by other organisms, and associated comorbidities ones).