by Lisa Saiman, MD, Columbia University, New York City
Abstract: Chronic pulmonary infection with Pseudomonas aeruginosa continues to be the most serious consequence of cystic fibrosis (CF). The pathogenesis of Pseudomonas infection in CF patients is not fully understood but seems to be a combination of unique properties of the organism and the exuberant host immune response. No single regimen appears most effective despite numerous clinical trials, but guidelines can be drawn from published studies and common clinical practice. In vitro susceptibility testing is important. In practice, 2 drugs with different mechanisms of action are usually chosen. Prolonged and frequent antibiotic use leads to emergence of multidrug-resistant strains of Pseudomonas. [Infect Med 10(7):37-43, 1993] Includes graphics.