Cystic fibrosis
ICD-10 E84 · ICD-11 CA25

Cystic Fibrosis with Positive Respiratory Culture for Pseudomonas aeruginosa

Pseudomonas aeruginosa — positive respiratory culture

This protocol applies to patients with cystic fibrosis whose respiratory culture has returned positive for Pseudomonas aeruginosa. The presence of this organism in a respiratory specimen is a clinically significant finding that warrants a specific, evidence-based management decision.


The approach involves selectively offering a targeted antibiotic route of administration — the decision to treat is guided by the positive culture result together with individual patient context. Not all patients meeting this criterion are managed identically; the protocol defines the selection criteria and the specific intervention.

Full regimen, selection criteria, and decision points are available in the complete protocol below.

The primary objective is clearance of Pseudomonas aeruginosa from subsequent respiratory cultures, confirmed by follow-up microbiological testing.

References
DOI: 10.1542/peds.2023-064657

The CFF recommends, for people with CRMS/CFSPID, selectively offering inhaled antibiotics for the treatment of Pa based on a positive respiratory culture (Grade C).
If the decision is to treat, then follow-up cultures are warranted to ensure Pa clearance.
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