THE PERFORMANCE OF A LONG-TERM ANTIBACTERIAL THERAPY IN CHILDREN WITH CYSTIC FIBROSIS DURING PRIMARY PLATING OF PSEUDOMONAS AERUGINOSA

Abstract

Background: A long-term plating of Pseudomonas aeruginosa in patients with cystic fibrosis is a sign of damage of the lung tissues with rapid progression of the disease and decrease in a respiratory function. The early pathogen detection is necessary for the timely prescription of an antibiotic for the purpose of a complete eradication of P. aeruginosa. Objective: Our aim was to determine the efficiency and safety of an inhalation form of the colistimethate sodium antibiotic in children with cystic fibrosis during the initial detection of P. aeruginosa. Methods: In a retrospective continuous study it was analyzed the results of inhalation use of the colistimethate sodium in a dose of 2 million IU/day in children with moderate cystic fibrosis with newly diagnosed P. aeruginosa. Results: The analysis included data of 25 children at the age of 2–10 years, 17 of them were treated with colistimethate sodium for 6 months, 8 — for 12 months. P. aeruginosa eradication was detected in 22 (88%) children. Children, who received antibiotic therapy for 6 months, at the end of the treatment showed an increase in forced expiratory volume for the 1st second (FEV-1) from 67.1 ± 2.2 to 80.4 ± 1.9% (р = 0.012), but in 3 months without inhalations there was a decrease in indicator values (to 75.9 ± 5.7%; p = 0.069). With the duration of inhalations of 12 months, the value FEV-1 indicator also increased: from 65.9 ± 3.8 to 81.5 ± 3.1% (р = 0.011). However, in the following 3 months without therapy these children did not have any significant decrease in FEV-1 (80.6 ± 3.4%; р = 0.073). There were no allergic reactions during the treatment; bronchospasm was observed in one child. For the entire period of management any P. aeruginosa strain, resistant to the colistimethate sodium, was not revealed. Conclusion: During the initial detection of P. aeruginosa in children with cystic fibrosis, a long-term therapy, including inhalations with colistimethate sodium, leads to a bacterial eradication and restoration of a respiratory function. Key words: children; cystic fibrosis; chronic Pseudomonas aeruginosa infection; treatment; colistimethate sodium; inhalations.

Keywords

• children
• cystic fibrosis
• chronic pseudomonas aeruginosa infection
• treatment
• colistimethate sodium
• inhalations