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J Cyst Fibros. 2013 Dec;12(6):638-43. doi: 10.1016/j.jcf.2013.04.013. Epub 2013 May 31.

Early treatment with inhaled antibiotics postpones next occurrence of Achromobacter in cystic fibrosis.

Author information

1
Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.

Abstract

OBJECTIVES:

In this nationwide retrospective study, we analysed species distribution, antimicrobial susceptibility and time to next occurrence of Achromobacter in Danish cystic fibrosis (CF) patients from 2000 to 2011.

METHODS:

Thirty-four primary isolates were identified to species level and subjected to antimicrobial susceptibility testing. Effectiveness of early antimicrobial treatment was assessed by a Kaplan-Meier estimation of time to recurrence.

RESULTS:

Achromobacter xylosoxidans accounted for 13 (38%) of the isolates, and an unnamed species accounted for 11 (32%) of the isolates. Meropenem, piperacillin-tazobactam and trimethoprim-sulfamethoxazole were highly active against chemotherapy-naïve Achromobacter, while ceftazidime, colistin and tobramycin were judged adequate for inhalation therapy. Fifty-five percent of 25 patients treated with inhaled ceftazidime, colistin, or tobramycin remained free of Achromobacter three years after acquisition, in contrast to 17% of 22 patients who did not receive inhaled antibiotics (P<0.01).

CONCLUSIONS:

Early treatment with inhaled antibiotics may prevent or postpone chronic infection with Achromobacter in CF patients.

KEYWORDS:

Achromobacter xylosoxidans; Cross-infections; Eradication; MLSA; Systemic therapy

PMID:
23727271
DOI:
10.1016/j.jcf.2013.04.013
[Indexed for MEDLINE]
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