Do you routinely use two empiric antibiotics to cover for Pseudomonas aeruginosa in the management of CF exacerbations?
Historically, two antibiotics have been used to cover Pseudomonas pulmonary exacerbations. The last guidelines were published in 2009 (Flume et al., PMID 19729669 ). At that time, the expert guidelines stated, "The CF Foundation concludes that there is insufficient evidence to recommend the use of a...
I fully agree with the answer; from personal experience, I have to say I have been a lot more comfortable and likely to use one antibiotic in recent years than before; this happened mainly because of toxicities and intolerances of aminoglycosides in older patients, so if you ask my personal default ...
Dual coverage has been the longstanding treatment option for patients with CF. Many are healthier now, live longer, so may have much more drug toxicity from IV aminoglycosides. I have stopped using dual coverage for everyone. I am anxiously awaiting the results of Stop 360.
I love this question and it's one whose answer I struggle with. I find it hard to justify dual agent (since the 2nd one is inevitably toxic as Dr Hadjiliadis noted) in those with a fairly pansensitive Pseudomonas aeruginosa species. I think the resistance pattern does matter. If you have someone wit...