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Clinical challenges in diagnosing and managing respiratory infection
P242 The treatment of pseudomonas aeruginosa (PA) in non-CF bronchiectasis
  1. O Hewitt1,
  2. L Mc Crossan2,
  3. R Hanna1,
  4. J Rendall1,
  5. J M Bradley3,
  6. J S Elborn2
  1. 1Regional Respiratory Centre City Hospital Belfast, Belfast, UK
  2. 2Queens University Belfast, Belfast, UK
  3. 3University of Ulster, Belfast, UK

Abstract

Introduction Pseudomonas aeruginosa (PA) is a common bacteria in bronchiectasis, and infection with PA is associated with worsening symptoms that may lead to an accelerated decline in FEV1.

Aims To review the current treatment of infection with PA, at the Regional Respiratory Centre, City Hospital Belfast to determine the success rate of eradication treatment and to assess if PA had any impact on lung function following 3 months of treatment.

Methods Medical notes of patients that had positive culture for PA requiring nebulised antibiotic treatment from August 2007 to October 2008 were reviewed. Where available, data relating to antibiotic therapy prescribed, presence of PA and lung function was recorded at the start of treatment, following 1 month of treatment and following 3 months of treatment.

Results Data from 91 patients, mean age (SD) 65 (11) years, baseline FEV1 1.5 (0.7) %, FVC 58 (21.4) % were analysed. 58/91 (64%) patients had a first ever recorded isolate of PA and 29/91 (32%) had previous sputum cultures with PA. First line treatment included oral ciproxin (n= 49/91; 54%) and IV anti pseudomonal antibiotics (n=27/91; 30%). 10/91 (11%) did not have a complete treatment due to side effects. Mean (SD) treatment duration of oral ciproxin was 3.67 (2.1) weeks; range 2–12 weeks. Patients were also prescribed nebulised antibiotic treatment: colomycin (n=84/91; 92%) and tobramycin (n=7/91; 8%). After 1 month of nebulised treatment (n=76) 55/76 (72%) had eradicated PA. Following 3 months of treatment (n=83), treatment of new isolates of PA in sputum was successful in eradication in 57/83 (69%) of patients. No improvements in lung function were noted.

Conclusions The success of treatment for PA eradication is similar to those reported in cystic fibrosis and current treatment does not adversely impact on lung function.

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