BACKGROUND

Chronic infection from PA in patients with BE is associated with worse outcomes and faster disease progression, hence eradication after first isolation is recommended. Although different PAE schemes have been proposed, none has demonstrated clear superiority.

Our study aims at evaluating the efficacy of PAE therapy with OC alone in a longitudinal cohort of BE patients with primary infection by PA.

METHODS

We retrospectively evaluated BE patients attending respiratory outpatient clinic of Hospital Universitari de la Vall d?Hebron, Barcelona (ES) with a primary infection by PA diagnosed between 2009 and 2019, and at least 3 years of microbiological follow-up. Data were collected about eradication (?3 negative sputum cultures in the year after treatment), and reinfection rate (new positive sputum culture after eradication) and correlated with demographic and clinical data.

RESULTS

We identified 85 patients, mean age of 65 years old, 63% females (54/85). Eradication was observed in 30 of the 41 cases treated with 21 days of OC (71%). In 21 more cases, it was achieved with other antibiotic strategies.

In 55% of PAE (28/51) reinfection was observed with variable latency, from 13 to 109 months (mean 38).

No correlation was found with exposure to quinolones or azithromycin chronic treatment.

CONCLUSION

Our data suggest that OC is a successful eradication strategy in a majority of BE patients. However, concern is raised by the elevated rate of reinfections, even after years from the first episode. Genotype studies could establish when reinfection is sustained by the same PA strain, while clinical data are needed to identify risk factors for unsuccessful eradication or reinfection.