Current dilemmas in antimicrobial therapy in cystic fibrosis

Abstract

The majority of cystic fibrosis (CF)-related morbidity and mortality is caused by pulmonary damage due to recurrent and chronic infections. Considerable improvements in the survival of individuals with CF have been achieved in recent decades, some of which may be due to better management of common pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. While the search continues for the optimal approach for prophylaxis, eradication and maintenance treatment of infections, there are several unanswered questions, posing dilemmas related to various therapeutic choices. Microbes pose additional challenges by adapting to CF lungs and developing treatment resistance. Several new, highly antimicrobial-resistant pathogens have emerged. Their pathogenic role in the progression of CF lung disease is not yet clear and effective treatment approaches have not been defined. There is an urgent need for well-designed comparative clinical trials of new antibiotic strategies.

Keywords::

• antibiotics
• cystic fibrosis
• Pseudomonas aeruginosa
• Staphylococcus aureus
• treatment

Financial & competing interests disclosure

K Jain has no conflicts to declare. AR Smyth has provided consultancy for Novartis Pharmaceuticals. He has also received payments from Rempex Pharmaceuticals for board membership and from Forest Pharmaceuticals for lectures. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.