Both the presence of P. aeruginosa and its phenotype (., developing a mucoid biofilm due to production of alginate as well as high-level resistance to multiple antibiotics) have been shown to correlate with severity of patient illness ( 55 ). This mucoid property predicts chronic infection that cannot be cleared. CF patients with P. aeruginosa have a decreased life expectancy of 30 years, compared with 40 years in non-colonized patients. They also experience a more rapid decline in pulmonary function and more frequent hospitalizations ( 72 ). On the other hand, anti-Pseudomonal therapy that decreases sputum colonization is associated with improved pulmonary function and improvement in clinical scores ( 174 ) [ See chapter on Cystic Fibrosis & P. aeruginosa . ] P. aeruginosa in the paranasal sinuses in cystic fibrosis patients frequently leads to acute and chronic infections, commonly complicated by nasal polyps. P. aeruginosa is otherwise an extremely rare finding in the sinuses in the non-cystic fibrosis population.
Fluoroquinolones, including FACTIVE, have been associated with an increased risk of central nervous system (CNS) effects, including convulsions, increased intracranial pressure (including pseudotumor cerebri ), and toxic psychosis . In clinical studies with FACTIVE, central nervous system (CNS) effects have been reported infrequently. As with other fluoroquinolones, FACTIVE should be used with caution in patients with CNS diseases such as epilepsy or patients predisposed to convulsions. CNS stimulation which may lead to tremors, restlessness, anxiety, lightheadedness , confusion, hallucinations, paranoia, depression, insomnia, and rarely suicidal thoughts or acts may also be caused by other fluoroquinolones. If these reactions occur in patients receiving FACTIVE, discontinue FACTIVE immediately and institute appropriate measures.