- Pseudomonas. Cystic Fibrosis Foundation website. Accessed June 1, 2021. https://www.cff.org/Life-With-CF/Daily-Life/Germs-and-Staying-Healthy/What-Are-Germs/Pseudomonas/
- Tramper-Stranders GA, van der Ent CK, Wolfs TFW. Detection of Pseudomonas aeruginosa in patients with cystic fibrosis. J Cyst Fibros. 2005;4 Suppl 2:37-43.
- Cystic fibrosis. US National Library of Medicine website. Updated August 18, 2020. Accessed June 1, 2021. https://medlineplus.gov/download/genetics/condition/cystic-fibrosis.pdf
- Moore JE, Mastoridis P. Clinical implications of Pseudomonas aeruginosa location in the lungs of patients with cystic fibrosis. J Clin Pharm Ther. 2017;42(3):259-267. doi:10.1111/jcpt.12521
- Hansen CR, Pressler T, Høiby N. Early aggressive eradication therapy for intermittent Pseudomonas aeruginosa airway colonization in cystic fibrosis patients: 15 years experience. J Cyst Fibros. 2008;7(6):523-530. doi:10.1016/j.jcf.2008.06.009
- Stuart B, Lin JH, Mogayzel PJ Jr. Early eradication of Pseudomonas aeruginosa in patients with cystic fibrosis. Paediatr Respir Rev. 2010;11(3):177-184. doi:10.1016/j.prrv.2010.05.003
- Cystic Fibrosis Foundation. 2019 Patient Registry Annual Data Report. Bethesda, MD: Cystic Fibrosis Foundation; 2019. Accessed June 1, 2021. https://www.cff.org/Research/Researcher-Resources/Patient-Registry/2019-Patient-Registry-Annual-Data-Report.pdf
- Cunningham JC, Taussig LM. Respiratory System. In: An Introduction to Cystic Fibrosis: For Patients and Their Families. 6th ed. Cystic Fibrosis Foundation; 2013:41-58.
- Li Z, Kosorok MR, Farrell PM, et al. Longitudinal development of mucoid Pseudomonas aeruginosa infection and lung disease progression in children with cystic fibrosis. JAMA. 2005; 293(5):581-588.
- Saiman L, Siegel JD, LiPuma JJ, et al. Infection prevention and control guideline for cystic fibrosis: 2013 update. Infect Control Hosp Epidemiol. 2014;35 Suppl 1:S1-S67. doi:10.1086/676882
- Cystic fibrosis. Mayo Clinic website. Accessed June 1, 2021. https://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/diagnosis-treatment/drc-20353706
- Bacteria and Antibiotic Resistance In People with Cystic Fibrosis. Cystic Fibrosis Foundation website. Accessed June 1, 2021. https://www.cff.org/PDF-Archive/Bacteria-and-Antibiotic-Resistance-in-People-With-CF
- Svedberg M, Gustafsson P, Tiddens H, Imberg H, Pivodic A, Lindblad A. Risk factors for progression of structural lung disease in school-age children with cystic fibrosis. J Cyst Fibros. 2020;19(6):910-916. doi:10.1016/j.jcf.2019.10.014
- Calthorpe RJ, Smith SJ, Rowbotham NJ, et al. What effective ways of motivation, support and technologies help people with cystic fibrosis improve and sustain adherence to treatment? BMJ Open Respir Res. 2020;7(1):e000601. doi:10.1136/bmjresp-2020-000601
- Bregnballe V, Schiøtz PO, Boisen KA, Pressler T, Thastum M. Barriers to adherence in adolescents and young adults with cystic fibrosis: a questionnaire study in young patients and their parents. Patient Prefer Adherence. 2011;5:507-515. doi:10.2147/PPA.S25308
- Bishay LC, Sawicki GS. Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis. Adolesc Health Med Ther. 2016;7:117-124. doi:10.2147/AHMT.S95637
- Zobell JT, Moss J, Heuser S, Roe L, Young DC. Understanding the expanding role of pharmacy services in outpatient cystic fibrosis care. Pediatr Pulmonol. 2021;56(6):1378-1385. doi:10.1002/ppul.25283
Help them keep up the fight against Pseudomonas aeruginosa
Pseudomonas aeruginosa
Did you know?
According to 2019 CFF Patient Registry Data
63%
of Pseudomonas aeruginosa
infections were chronic in 2019.7
It’s no surprise that for your patients with cystic fibrosis (CF), managing Pseudomonas aeruginosa along with taking other multiple treatments can be a burden.
And yet, treating Pseudomonas aeruginosa remains a critical part of CF care:
- It is still the most common chronic lung pathogen in adults 25 and older with CF as of 20197
- Acquisition is associated with decreased survival4
- It can progress to mucoid Pseudomonas aeruginosa, a strain that is more difficult to treat and can impair lung structure and function5,6
- Over time, it can cause permanent lung damage such as scar tissue and pulmonary cysts3
While the prevalence of Pseudomonas aeruginosa continues to decrease over time, the likelihood of infection increases for those over 24 years of age.7
- P. aeruginosa prevalence
by year (1993-2019) - P. aeruginosa prevalence
by age cohort (2019)
Adapted from 2019 CF Foundation Patient Registry Annual Data Report
Adherence to treatment
If your patients are feeling better on their other CF treatments, they may choose to forego their Pseudomonas aeruginosa treatment without consulting you. Your patients may choose to take a break from treating their Pseudomonas aeruginosa.
When patients take a break from treatment, they may need to be reminded of:
- The risks associated with stopping treatment3,5,6,9
- The fact that only inhaled antibiotics are indicated for people with CF and chronic Pseudomonas aeruginosa
- There are no data on the long-term outcomes of stopping treatment for Pseudomonas aeruginosa in this new era of CF treatments
Potential strategies to improve adherence
Communication
Help them understand why certain treatments are necessary.
“Sometimes I do stop having that conversation. I assume we’ve been over it and they know what Pseudomonas aeruginosa is. Maybe I should be having that conversation more. It is something we could talk about again and maybe it would improve their compliance.” - HCP
Shared decision-making
Encourage patients to take an active role in their care plans.
Technology
Allow patients to gather and keep track of their own data using digital and app-based technology.
Individualization
Incorporate adherence discussions based on the individual—their barriers, lifestyle, and determinants of health.16
Offer access-based solutions
Pharmacists can play an important role in helping with access, cost, and even adherence. Connecting patients to a respiratory CF pharmacist may help increase adherence.17
Shared decision-making
Encourage patients to take an active role in their care plans.
Individualization
Incorporate adherence discussions based on the individual—their barriers, lifestyle, and determinants of health.16
Telehealth
Telehealth and virtual clinics can provide the opportunity for earlier intervention and improved monitoring and self-management, as well as the use of real-time applications for adherence monitoring.
“I’m concerned that Pseudomonas aeruginosa could be hiding in my lungs.”