[Cystic fibrosis and pseudomonas aeruginosa current and future strategies].

Cystic fibrosis and Pseudomonas aeruginosa current and future strategies Pseudomonas aeruginosa is long recognized as the main pathogen in cystic fibrosis and avoiding or postponing chronic colonization of the lungs by this germ is considered as the most important challenge for the clinicians dedicated to the care of CF patient. The need for early intervention is widely accepted but its optimal modalities are still debated and the failure rate of this approach is estimated around 20%. This underlines the potential of other strategies including attempts to develop an effective vaccine against PA and anti-PA prophylaxis. Surprisingly enough, the latter approach which could involve early use of inhaled antibiotics has never been studied prospectively. In chronically colonized patients, inhaled antibiotics and oral azythromycin are of value, slowing the FEV1 decline and reducing the number of exacerbations. Whether intravenous antibiotics are to be used electively (during exacerbations) or more systematically (every 3 months for example) remains controversial.