PURPOSE:Pseudomonas aeruginosa remains a major pathogen of most of the patients with CF, and most of them are chronically infected by their early teens.To determine if regular elective 3/4 monthly antibiotics improves lung function and weight of CF patients colonised with pseudomonas aeruginosa.
METHODS:This is a retrospective study reviewing the case-notes of all 13 patients in the BHH Cystic Fibrosis centre who were on regular elective 3/4 monthly antibiotics during the period January to December 2006 and were colonised with pseudomonas in the sputum. Eleven patients were included. The best PFTs and weights that were taken every 4 months were used in this study. Values for PFTs and weights taken during the first 4months of the year were denoted as A [base line], for the next 4 months as B [mid-point], last 4 months as C [end-point]. These results were compared with a control group of 22 patients treated with antibiotics during exacerbations only. Results were analysed using STATA version 9 [paired t-test].
RESULTS:Results of this study showed no significant difference in the FEV1 A (base line) and FEV1C (end point) [p=0.053, 95% CI -0.27 to 0.002]; FVC A (base line) and FVC C (end point) [p=0.061, 95% CI -0.67 to 0.02] and weight A (base line) and weight C (end point) [p=0.73, 95%CI -1.6 to 1.17] of these CF patients treated with regular IV antibiotics and colonised with pseudomonas at the end of the year compared with the beginning. This compares with the annual decline seen in the lung function and weight of the control group of CF patients at our centre treated with IV antibiotics only for infective exacerbations during the same period, which were statistically not significant (FEV1 [p=0.80, 95%CI -0.55 to 0.71]; FVC [p=0.55, 95%CI -0.47 to 0.86], weight p=0.91; 95%CI -6.8 to 6.15).
CONCLUSION:Regular 3/4 monthly antibiotics did not improve the lung function or weight of these CF patient.
CLINICAL IMPLICATIONS:These results show no advantage of elective antibiotics over symptomatic treatment. More studies are needed.
DISCLOSURE:Bassey Asuquo, None.