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CF – chronic Pseudomonas — RACP Paediatrics MCQ

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ModerateRespiratoryCF – chronic PseudomonasRACP Paediatrics

A 10-year-old with CF has chronic Pseudomonas aeruginosa colonisation. Despite regular chest physiotherapy and dornase alfa, FEV1 continues to decline. What additional treatment should be considered to reduce exacerbation frequency?

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Correct answer: C — Azithromycin prophylaxis

Long-term azithromycin (3 times per week) has been shown to reduce pulmonary exacerbation frequency in CF patients chronically colonised with Pseudomonas. Its benefit is thought to be via anti-inflammatory and immunomodulatory effects rather than direct antibacterial action. Inhaled tobramycin is used for chronic Pseudomonas suppression.

Reference: Australian Therapeutic Guidelines – 2024 – Respiratory; RCH Melbourne – 2023 – CF CPG