RT Journal Article
SR Electronic
T1 Alternating inhaled antibiotic therapy in CF: A single center analysis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1295
DO 10.1183/13993003.congress-2015.PA1295
VO 46
IS suppl 59
A1 C. Van de Kerkhove
A1 M. Kicinski
A1 P.C. Goeminne
A1 T.S. Nawrot
A1 L.J. Dupont
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA1295.abstract
AB Introduction: The efficacy of inhaled antibiotics on chronic Pseudomonas aeruginosa infections in patients with cystic fibrosis (CF) has been well established. Little data are available on the value of combination inhaled therapy (CIT), a strategy frequently used in management of CF.Objective: To investigate the effect of CIT on FEV1 in CF patients at the University Hospital of Leuven.Methods: Spirometry data of adult CF patients receiving CIT between Mar 2010 - Jan 2015 were collected retrospectively at fixed time points outside an exacerbation, from 6 months before to 1 year after introduction of a 2nd inhaled antibiotic.Results: 50 of 99 patients using chronic inhaled antibiotic therapy, received CIT. During monotherapy all patients experienced a monthly decline in FEV1. At start of CIT mean FEV1 was 52%. Mean duration of CIT was 59 weeks. A combination of aztreonam lysine for inhalation solution (AZLI) with colistimethate sodium dry powder inhalator (Coli DPI) was the most frequent CIT used (34%). Patients originally treated with AZLI experienced a significant improvement in FEV1 of 0.78% per month (p= 0.05) after the addition of coli inhalation solution or DPI. Coli treated patients exhibited an average increase in FEV1 of 0.57% per month (p=0.10) after adding tobramycin inhalation solution (TIS) or AZLI. The addition of nebulised coli to TIS was associated with a monthly increase in FEV1% of 0.75% (p= 0.03).Conclusion: CIT appears to be associated with a small but significant improvement in FEV1 in CF patients under monotherapy. On the basis of this retrospective analysis we cannot determine the superiority of one particular CIT over another. Further research is warranted to identify the value of CIT.