Document Detail

Shifting patterns of inhaled antibiotic use in cystic fibrosis.
MedLine Citation:
PMID:  18668689     Owner:  NLM     Status:  MEDLINE    
RATIONALE: Antibiotic inhalation has become widely accepted as a standard treatment for cystic fibrosis (CF) airway infection. We assessed the prevalence and context of inhaled antibiotic use in the North American CF population. Our working hypothesis was that a shift from acute to chronic use of inhaled antibiotics has coincided with increased prevalence of use among CF patients.
METHODS: Descriptive statistics were collected for 30,833 patients enrolled in the Epidemiologic Study of CF (ESCF) during 1996 through 2005. A multivariate analysis was performed on data from a subgroup of 18,021 patients enrolled in ESCF during 2003 through 2005.
RESULTS: The prevalence of inhaled antibiotic use in the North American CF population increased during 1996 through 2005 due to increased chronic use, while acute use to treat pulmonary exacerbations decreased. In 2005, 50% of CF patients used inhaled tobramycin and 9% used inhaled colistin chronically; most of the latter used both agents concurrently. Airway obstruction severity and airway infection status were predictors of inhaled antibiotic use.
CONCLUSIONS: Increased chronic use and decreased acute use of inhaled antibiotics presumably reflect a shift toward more proactive management of airway infections in the North American CF population. The effects of these usage patterns on long-term clinical outcomes and emergence of antibiotic-resistant Pseudomonas aeruginosa strains warrant further study.
Samuel M Moskowitz; Stefanie J Silva; Nicole Mayer-Hamblett; David J Pasta; David R Mink; Jenny A Mabie; Michael W Konstan; Jeffrey S Wagener;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  43     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-01     Completed Date:  2009-02-24     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  874-81     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
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MeSH Terms
Administration, Inhalation
Anti-Bacterial Agents / administration & dosage*
Child, Preschool
Colistin / administration & dosage*
Cystic Fibrosis / complications*
Drug Utilization / statistics & numerical data
Respiratory Tract Infections / drug therapy*,  etiology*
Tobramycin / administration & dosage*
Grant Support
K08 HL067903/HL/NHLBI NIH HHS; K08 HL067903-05/HL/NHLBI NIH HHS; R01 AI067653/AI/NIAID NIH HHS; R01 AI067653-01A2/AI/NIAID NIH HHS; R01 AI067653-02/AI/NIAID NIH HHS
Reg. No./Substance:
0/Anti-Bacterial Agents; VZ8RRZ51VK/Tobramycin; Z67X93HJG1/Colistin

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