146 Pseudomonas serology can guide aggressive Pseudomonas eradication programmes

Abstract

Background: Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) leads to a negative impact in disease evolution and enforces therapeutic programs for controlling and eradication of this infection. Objectives: The assessment of tobramycin inhaled therapy in patients with CF associated with P. aeruginosa chronic lung infection. Methods: The study includes 15 patients with CF associated with chronic airway infection with P. aeruginosa. CF diagnosis was confirmed through positive sweat test and genetic testing of the CFTR mutations. The patients’ average age was 14.86±5.6 years (8−25 years). Tobramycin aerosol therapy (TOBI 300mg/5ml) was performed in an alternating program (300mg ×2, 28 days 4−6 cycles). Respiratory FVC and FEV1 indices were used for lung function monitoring. Results: Before starting tobramycin treatment, all the patients showed decreased spirometric indices: FVC (63.66±1.64%) and FEV1 (59.8±1.46%). After 12 months of treatment, these indices improved to FVC 67.23±1.11%, FEV1 62.95±2.33%. Inhaled tobramycin treatment also determined a suppression of P. aeruginosa infection in patients with CF. P. aeruginosa titres were 103−108 (mean titre 6.31±0.11) before the treatment and decreased with 1−3 titres in 46.7% of cases. P. aeruginosa infection was completely eradicated in 13.3% of cases. Conclusion: Tobramycin aerosol therapy helps to control and eradicate P. aeruginosa lung infection and improves respiratory function by increasing FVC and FEV1 spirometric indices.