Clinical cases of Pseudomonas aeruginosa eradication in patients with cystic fibrosis

Abstract

Pseudomonas aeruginosa is the most common highly pathogenic flora in patients with cystic fibrosis. It is associated with severe lung damage and affects life expectancy. According to the register of patients with cystic fibrosis in the Russian Federation (2019), the incidence of P. aeruginosa pulmonary infection among them is 34.3%. Inhaled tobramycin is the drug of choice for the eradication of P. aeruginosa in patients with cystic fibrosis according to European and Russian recommendations. Clinical studies showed that Bramitob is highly effective against P. aeruginosa infection in patients with cystic fibrosis.The aim of the study: to demonstrate the effectiveness and safety of eradication therapy with inhaled tobramycin in several clinical cases of children with cystic fibrosis.Methods. The article analyzes 6 clinical cases of effective eradication of P. aeruginosa in patients with cystic fibrosis, including 1 clinical case that involved a new approach to assessing the resistance of P. aeruginosa. Positive culture of P. aeruginosa was confirmed in all patients in specialized laboratories (State Budgetary Healthcare Institution “Morozov Children’s City Clinical Hospital of the Department of Health of the City of Moscow”, Federal State Budgetary Institution “N.F.Gamaleya National Research Center for Epidemiology and Microbiology”, Ministry of Health of the Russian Federation). All patients received inhaled tobramycin 300 mg 2 times a day for 1 – 3 courses (a course of 28 days of inhalations/28 days – a break).Results. All children tolerated tobramycin well, and two of them were younger than 6 years old. The effectiveness of eradication was confirmed by negative cultures of P. aeruginosa during 1-year follow-up that included quarterly microbiological control. The clinical case that involved assessment of resistance to inhaled tobramycin is especially important because of polyresistance of the pathogen.Conclusion. The presented clinical cases of eradication of P. aeruginosa with the use of tobramycin confirm its clinical efficacy and wider application possibilities.