Document Detail


Oral, inhaled, and intravenous antibiotic choice for treating pulmonary exacerbations in cystic fibrosis.
MedLine Citation:
PMID:  22888106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: Patients with cystic fibrosis (CF) experience frequent pulmonary exacerbations (PExs). Clinicians manage these episodes of worsening signs and symptoms in a variety of ways.
OBJECTIVES: To characterize the antibiotic management and associated change in lung function following PExs.
METHODS: We used 2003-2005 data from the Epidemiologic Study of Cystic Fibrosis to examine antibiotic treatment and the immediate and long-term lung function change associated with clinician reported PExs.
RESULTS: A total of 45,374 PExs were reported in 13,194 unique patients. Most PExs (73%) were treated with oral antibiotics, while 39% were treated IV and 24% were treated with inhaled antibiotics. The likelihood of non-IV versus IV antibiotic treatment was associated with the patient's age, stage of lung disease, and magnitude of lung function drop prior to the PEx. Following treatment, the average improvement in the FEV1 was 3.4 ± 12.2% predicted with a greater (5.1 ± 12.7% predicted) improvement following IV antibiotic treatment than with non-IV treatment (2.0 ± 11.6% predicted). When the best FEV1 from the year before was compared with 180 days following the PEx there was an average fall of 3.8 ± 10.5% predicted with little difference observed between antibiotic treatment routes. Patients with only one exacerbation during the 3-year study had a similar loss of lung function to patients with no reported exacerbations.
CONCLUSION: Clinicians treat the majority of PExs with oral antibiotics, particularly in younger, healthier patients. Pulmonary function improves with antibiotic therapy, however, PExs are associated with lung function deterioration over time.
Authors:
Jeffrey S Wagener; Lawrence Rasouliyan; Donald R VanDevanter; David J Pasta; Warren E Regelmann; Wayne J Morgan; Michael W Konstan;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-08
Journal Detail:
Title:  Pediatric pulmonology     Volume:  48     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-20     Completed Date:  2014-01-31     Revised Date:  2014-04-14    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  666-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Administration, Intravenous
Administration, Oral
Adolescent
Adult
Age Factors
Anti-Bacterial Agents / therapeutic use*
Child
Child, Preschool
Cystic Fibrosis / complications,  drug therapy*
Disease Progression
Female
Forced Expiratory Volume
Humans
Male
Respiratory Tract Infections / complications,  drug therapy*
Severity of Illness Index
Young Adult
Grant Support
ID/Acronym/Agency:
P30 DK027651/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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