[Pseudomonas aeruginosa infections in chronic obstructive pulmonary disease : Role of long-term antibiotic treatment].

Chronic Pseudomonas aeruginosa colonization in the airways of patients with chronic obstructive pulmonary disease (COPD) is probably associated with increased mortality and morbidity and a faster progress of COPD, although this has not been conclusively proven by studies. Studies demonstrating an improvement in prognosis in COPD patients by early eradication of Pseudomonas or at least a reduction of the bacterial burden by either inhaled or oral antibiotic maintenance therapy, are missing. An impact on the exacerbation rate has only been shown for macrolide maintenance treatment; however, this effect could be explained by the inclusion of patients with bronchiectasis in the studies. This is a group of patients for whom the effect of this kind of antibiotic treatment is well known. Further studies on the prevention and treatment of chronic Pseudomonas colonization in COPD patients are urgently needed. The stability of the respiratory microbiome probably plays an essential role in the course of the disease and should be established as a study endpoint.