Document Detail

Long-term follow up of changes in FEV1 and treatment intensity during Pseudomonas aeruginosa colonisation in patients with cystic fibrosis.
MedLine Citation:
PMID:  10319054     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Colonisation with Pseudomonas aeruginosa (PA) is a striking feature of lung involvement in cystic fibrosis. To identify the clinical consequences of the different steps of colonisation with PA under a defined therapeutic regime (no prophylactic antibiotic treatment as long as patients had no severe pulmonary disease), their influence on pulmonary function and on therapeutic intensity was examined. METHODS: Forty patients with cystic fibrosis were followed from first detection of PA (PA1), chronic PA colonisation (PAc), first mucoid PA detection (PAm), to chronic mucoid PA colonisation (PAcm). Percentage predicted forced expiratory volume in one second (FEV1), the number of intravenous antibiotic treatment courses, and the percentage of patients on inhaled antibiotics were followed retrospectively and longitudinally in relation to the different steps of PA colonisation. The annual changes in FEV1 and therapeutic intensity in the two years preceding each step were compared with the two years following each step. Changes in FEV1 were related to therapeutic intensity. RESULTS: The mean (SD) annual changes in FEV1 (% predicted) worsened significantly only with the transition to the mucoid stages (PAm: 4.6 (13.2) versus -4.3 (8.1); PAcm: 7.3 (12.0) versus -4.8 (7.4)) with a mean difference (95% CI) between before and after the transition of 8.9 (2.6 to 15.2) for PAm and 12.1 (6.4 to 17.6) for PAcm. With non-mucoid PA stages the therapeutic intensity increased in the year of transition and with mucoid PA stages it increased in the years following transition. Therapeutic intensity was unrelated to changes in FEV1. CONCLUSION: With the treatment regime used an accelerated decrease in FEV1 was successfully prevented in the non-mucoid stages but not in the mucoid stages of PA colonisation.
M Ballmann; P Rabsch; H von der Hardt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thorax     Volume:  53     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1999-05-13     Completed Date:  1999-05-13     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  732-7     Citation Subset:  IM    
Medical School Hannover, Germany.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Cystic Fibrosis / complications,  microbiology,  physiopathology*
Forced Expiratory Volume / physiology
Longitudinal Studies
Pseudomonas Infections / complications,  drug therapy,  physiopathology*
Pseudomonas aeruginosa
Retrospective Studies
Reg. No./Substance:
0/Anti-Bacterial Agents

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