Pseudomonas Aeruginosa Infection as a Complication of Therapy in Pancreatic Fibrosis (Mucoviscidosis)

Four cases of proved pancreatic fibrosis in which Ps. aeruginosa was the organism associated with the terminal, bronchopulmonary manifestations have been presented. These children had received prolonged antibacterial therapy varying from one to five years. Ps. aeruginosa, or similarly resistant organisms, which ordinarily have a low pathogenicity, may become predominant and invasive as a result of prolonged antibacterial therapy. The opportunity for the emergence of resistant strains would seem to be enhanced by recent recommendations advocating continuous antibacterial therapy with a single compound. Intermittent therapy, alternating the various antibacterial agents and correlating their use with careful bacteriologic studies of the nasopharyngeal and tracheobronchial flora, would seem to be the logical approach to treatment in the light of present knowledge of the development of bacterial resistance. Mixtures of two antibiotics having a different mechanism of action may be more desirable than the use of a single agent.