Table 6: Treatment of chronic infection.

Agent

Nebulized

Oral or intravenous

Pseudomonas

Tobramycin (solution

for nebulization):

300 mg/5 mL twice

daily 28 days of treatment

followed by 28 days

of rest in e-Flow®,

Pari LC plus®

Gentamicin (inhaled

intravenous formulation):

80 mg twice daily

continuous treatment

If despite nebulized treatment poor clinical control persists, associate an oral or intravenous antibiotic with activity according to antibiogram, on demand or in cycles

MRS

Vancomycin (intravenous

formulation administered

by nebulized route):

250 mg/2 times a day

continuous treatment

If the response is insufficient or there is intolerance, add or replace vancomycin with IV linezolid

Other germs

Gentamicin:

80 mg/2 times daily

or any of those used for

pseudomone continuous

treatment

If the response is insufficient or there is intolerance, consider adding (or replacing) the nebulized antibiotic with an oral one according to sensitivity

MRS = Methicillin-resistant Staphylococcus aureus.