Early antibiotic treatment of pseudomonas aeruginosa colonisation in cystic fibrosis: a critical review of the literature

Marchetti, Federico; Giglio, L.; Candusso, M.; Faraguna, D.; Assael, B.M.

doi:10.1007/s00228-004-0735-2

Cited by 25 publications

(19 citation statements)

References 32 publications

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“…Another pitfall of P. aeruginosa susceptibility testing in CF patients is the ever-increasing use of aerosolized agents, especially tobramycin and colistin [3]. Susceptibility testing is based on serum-achievable levels of the antimicrobial of interest.…”

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confidence: 99%

“…Clearly, it can provide little guidance in CF patients infected chronically with P. aeruginosa for the reasons already discussed. However, it may offer guidance in patients in the early stages of P. aeruginosa infection in whom eradication using aerosolized antimicrobials, either alone or in combination with oral fluoroquinolones [3], is being attempted. In the early stages of CF disease, the planktonic mode of growth predominates and it is also less likely that the organisms are growing under anaerobic conditions [2].…”

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confidence: 99%

“…These organisms grow as individual cells, 'planktonically' [2]. There is a developing body of evidence indicating that aggressive treatment with aerosolized antimicrobials, such as colistin or tobramycin, at the time of initial P. aeruginosa infection may permit the eradication of this organism and prevent the establishment of chronic infections for many months or years [3]. There is ample evidence that supports the notion that delay of chronic infection with this organism improves both patient survival and quality of life [3].…”

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Is there value in susceptibility testing ofPseudomonas aeruginosacausing chronic infection in patients with cystic fibrosis?

Gilligan

2006

Expert Review of Anti-infective Therapy

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confidence: 99%

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Is there value in susceptibility testing ofPseudomonas aeruginosacausing chronic infection in patients with cystic fibrosis?

Gilligan

2006

Expert Review of Anti-infective Therapy

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“…Tobramycin is approved antibiotic in the United States and highly recommended for patients with CF to delay colonization of P. aeruginosa in the lungs (237). Six different independent studies showed significant improvement of lung functions in patients with moderate to severe CF and decreased chronic P. aeruginosa count and weight gain following tobramycin treatment compared to placebo or standard treatment (174,(238)(239)(240)(241)(242). Tobramycin delayed biofilm formation of P. aeruginosa as well as disruption of already formed biofilms thereby limits the growth of P. aeruginosa (243).…”

Section: Current Therapeutic Optionsmentioning

confidence: 99%

“…Patients with CF are treated with antibiotics to prevent and eradicate respiratory infections (241). Aminoglycoside antibiotics such as tobramycin, gentamicin has been shown to restore expression of full-length functional CFTR and significant increase of cAMP-activated chloride channel (180,263).…”

Section: Macrophages: the Missing Link In Cf Inflammation?mentioning

confidence: 99%

Macrophage Polarization and Function in Cystic Fibrosis

Tarique¹

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If "Diversity is the rule of nature", macrophages, one of the innate immune cells of our body, have proven to be a true apostle. At the early stage of infection, they protect the host by exhibiting the pro-inflammatory phenotype (M1). Upon clearance of microbial threats, macrophages engage themselves in the repair process of the damaged tissue by showing anti-inflammatory or wound healing (M2) attributes. While incomplete microbial clearance leads to recurrent infections, defects in macrophage-mediated tissue repair mechanism result in immunopathology. The classical (M1) and alternatively (M2) polarized macrophages are the two extreme ends of a spectrum of in vivo macrophages phenotypes that dictate the nature, duration and severity of inflammation. Murine models of chronic inflammatory and autoimmune diseases showed the necessity of an adequate balance between macrophage subsets to maintain homeostasis, while imbalance is likely to lead exaggerated inflammation. In humans, an association between defective macrophage function and disease severity has been reported in many diseases including asthma, cystic fibrosis (CF), COPD, and atherosclerosis. Unfortunately, human M1 and M2 macrophages have not been well characterized. Firstly, the lack of homologs for certain murine genes in humans makes murine markers of limited use in humans. Secondly, there was no consensus method for in vitro differentiation of human M1 and M2 macrophages. Therefore, the first part of this thesis aimed to develop a novel method to differentiate and characterize human M1 and M2 macrophages. Initial studies with THP-1 cell line derived macrophage-like cells demonstrated that they didn't fully represent human monocyte-derived macrophages (MDMs). MDMs were therefore chosen as starting materials for the rest of the study. MDMs were considered as uncommitted "M0" macrophages. A number of inducers were employed to polarize M0 macrophages into either M1s or M2s. LPS treated M1 macrophages showed CD64 + CD80 + phenotype, whereas, IFN- induced M1s exhibited CD64 ++ CD80 -phenotype. These M1s secreted pro-inflammatory cytokines including TNF-, IL-1, IL-8 and were highly phagocytic. On the contrary, IL-4/IL-13 induced M2 macrophages were identified as CD11b + CD209 + cell population and were endocytic. Once polarized, macrophages then were left in cytokine-deficient medium to assess the persistence of polarized phenotype over time. In cytokine-free condition, previously polarized macrophages reverted to M0 state by 12 days.Treatment with IL-13 on previously polarized M1 macrophages resulted in a switch to CD209 + M2sand vice versa indicating the plasticity nature of human macrophages.Excessive neutrophilic pulmonary inflammation is the hallmark of cystic fibrosis (CF).However, factors that trigger such dysregulated neutrophilic inflammation and why this is not

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Shifting patterns of inhaled antibiotic use in cystic fibrosis

Moskowitz

Silva

Mayer-Hamblett

et al. 2008

Pediatric Pulmonology

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Early antibiotic treatment of pseudomonas aeruginosa colonisation in cystic fibrosis: a critical review of the literature

Abstract: Evidence was found that antibiotic treatment can reduce the rate of positive cultures and of anti-PA antibody titres in asymptomatic CF patients with newly isolated PA. Different therapeutic options have not been directly compared: a multi-centre comparative study needs to be carried out.

Cited by 25 publications

References 32 publications

Is there value in susceptibility testing ofPseudomonas aeruginosacausing chronic infection in patients with cystic fibrosis?

Is there value in susceptibility testing ofPseudomonas aeruginosacausing chronic infection in patients with cystic fibrosis?

Macrophage Polarization and Function in Cystic Fibrosis

Shifting patterns of inhaled antibiotic use in cystic fibrosis

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