Treatment of “first growth” Pseudomonas Aeruginaosa
The Cystic Fibrosis team is recommending a specific treatment protocol for you/your child, because of the presence of a certain bacterium found on throat culture or sputum specimen. The bacterium is called “Pseudomonas Aeruginosa”. Since it has such a long complicated name, we’ll refer to it as “Psa”. Most people with CF get Psa at some time, the average age 10 years. Often the individual is not ill at the time they acquire Psa. Over time, Psa will take up residence in the lungs, and form a colony. A Psa colony can seldom be eliminated, but medications and treatments can help to shrink and manage it. Psa can also cause infection which can damage the lungs over time. Having Psa does not signal a downhill slide in health; however, it’s better not to have it if at all possible.
Not long ago, it was believed that once Psa was found in the lungs, it could never be eliminated. We now believe there is a “window of opportunity” to eliminate the bacteria with aggressive treatment. The treatment protocol that we recommend is adapted from one being used very successfully in Denmark, and is based on expert CF knowledge and many years of experience in treating CF. Our clinic has been using this treatment protocol since 1995. At that time, 44% of our CF patients had Psa in their lungs. As of 2005, only 18% have Psa in their lungs, which we believe is due to this treatment protocol (along with usual daily treatments which aim to delay progression of lung disease, such as regular chest physiotherapy, etc).
Although it is likely that Psa (usually a different strain) will return at some point (our protocol has eliminated Psa for an average of two years), we believe that the treatment is absolutely worthwhile. Time “free” from Psa means that possible cycles of infection will be delayed or avoided, and in the meantime, researchers are busy working on other treatments such as a Psa vaccine. We recognize that the treatment protocol is quite intensive, expensive, and time consuming, and our CF team will be happy to support you as much as possible.