Abstract
Pseudomonas aeruginosa (PA), a gram-negative rod-shaped bacterium, is one of the most common pathogens causing colonization and infection of the respiratory tract and lungs in patients with cystic fibrosis (CF). Antibiotic therapy is the mainstay treatment for PA infection, and tobramycin is one of the widely used antibiotics in intravenous or inhalation form. This review aims to explore if there is any advantage of adding systemic antibiotics to tobramycin inhalation therapy by comparing the combination regimen to tobramycin inhalation monotherapy in CF patients with PA infection. We collected studies relevant to our review topic by doing a literature search on multiple databases. According to the currently available studies, the addition of oral antibiotics such as fluoroquinolones and azithromycin to tobramycin inhalation solution (TIS) provides no additional benefit in eradicating PA infection or producing clinical improvement in cystic fibrosis patients. However, adding intravenous antibiotics to TIS has not produced conclusive results and thus requires further research. We recommend conducting more randomized controlled trials comparing different treatment regimens, which may help discover the most beneficial treatment regimen with decreased systemic side effects.
Highlights
BackgroundCystic fibrosis (CF), a common disease among people of northern European descent, is an autosomal recessive genetic disorder [1]
We aim to ascertain if the addition to tobramycin inhalation solution (TIS) therapy of an oral or IV antibiotic against P. aeruginosa proves to enhance the efficacy of TIS against P. aeruginosa infection in cystic fibrosis (CF) patients
The results showed that the recurrence rates and time to recurrence were not significantly different between the two groups; all patients receiving IV antibiotics in combination with TIS achieved eradication, unlike those receiving TIS monotherapy [14]
Summary
BackgroundCystic fibrosis (CF), a common disease among people of northern European descent, is an autosomal recessive genetic disorder [1]. The incidence of CF is estimated between 1 in 3,000 to 1 in 6,000 live births [2,3] The cause of this disorder is a mutation in the cystic fibrosis transmembrane regulator (CFTR) proteincoding gene [1]. The abnormal chloride secretion in CF affects multiple organs, notably the upper and lower respiratory tracts, pancreas, bowel, reproductive tract, and causes sinopulmonary infections, pancreatic insufficiency, infertility [1,4]. Among these complications, pulmonary infections are the most common cause of morbidity and mortality in CF patients [1,4]
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