Maintenance treatment with antibiotics in cystic fibrosis patients. Sense or nonsense?

Abstract

The majority of patients with cystic fibrosis (CF) have chronic lung infection with a variety of organisms. It is accepted clinical practice to treat acute exacerbations of infection with appropriate oral or intravenous antibiotics. The aim of this paper is to review the use of maintenance antibiotics for these patients with chronic pulmonary infection. There is clinical trial evidence to support the use of maintenance treatment for patients chronically infected with Staphylococcus aureus or Pseudomonas aeruginosa. No such evidence is available in the case of Haemophilus influenzae or Burkholderia cepacia. Chronic infection with Staphylococcus aureus is commonly treated with maintenance oral flucloxacillin and chronic infection with Pseudomonas aeruginosa either with 3-monthly intravenous antibiotics or long-term aerosol antibiotics. Further clinical trials need to be performed on many aspects of maintenance treatment for CF patients with chronic pulmonary infection.