Early treatment with inhaled antibiotics postpones next occurrence of Achromobacter in cystic fibrosis

J Cyst Fibros. 2013 Dec;12(6):638-43. doi: 10.1016/j.jcf.2013.04.013. Epub 2013 May 31.


Objectives: In this nationwide retrospective study, we analysed species distribution, antimicrobial susceptibility and time to next occurrence of Achromobacter in Danish cystic fibrosis (CF) patients from 2000 to 2011.

Methods: Thirty-four primary isolates were identified to species level and subjected to antimicrobial susceptibility testing. Effectiveness of early antimicrobial treatment was assessed by a Kaplan-Meier estimation of time to recurrence.

Results: Achromobacter xylosoxidans accounted for 13 (38%) of the isolates, and an unnamed species accounted for 11 (32%) of the isolates. Meropenem, piperacillin-tazobactam and trimethoprim-sulfamethoxazole were highly active against chemotherapy-naïve Achromobacter, while ceftazidime, colistin and tobramycin were judged adequate for inhalation therapy. Fifty-five percent of 25 patients treated with inhaled ceftazidime, colistin, or tobramycin remained free of Achromobacter three years after acquisition, in contrast to 17% of 22 patients who did not receive inhaled antibiotics (P<0.01).

Conclusions: Early treatment with inhaled antibiotics may prevent or postpone chronic infection with Achromobacter in CF patients.

Keywords: Achromobacter xylosoxidans; Cross-infections; Eradication; MLSA; Systemic therapy.

MeSH terms

  • Achromobacter*
  • Administration, Inhalation
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / microbiology*
  • Drug Resistance, Microbial
  • Female
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / prevention & control
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Secondary Prevention*
  • Sputum / microbiology
  • Young Adult


  • Anti-Bacterial Agents