Characteristics and outcomes of oral antibiotic treated pulmonary exacerbations in children with cystic fibrosis

Autor: Jordana E. Hoppe, Scott D. Sagel, Edith T. Zemanick, Frank J. Accurso, Brandie D. Wagner
Rok vydání: 2018
Předmět:
Lung Diseases
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
HMGB
Human mobility group box
Adolescent
Cystic Fibrosis
Exacerbation
medicine.drug_class
Antibiotics
Administration
Oral
PES
Pulmonary exacerbation score
Cystic fibrosis
Article
Sputum culture
PEx
Pulmonary exacerbation
03 medical and health sciences
0302 clinical medicine
Quality of life
Internal medicine
medicine
Humans
Pulmonary exacerbation
030212 general & internal medicine
Respiratory system
Child
Inflammation
Bacteria
medicine.diagnostic_test
business.industry
medicine.disease
Lung function
United States
Anti-Bacterial Agents
Respiratory Function Tests
3. Good health
Treatment Outcome
030228 respiratory system
NE
Neutrophil elastase
Pediatrics
Perinatology and Child Health
Cohort
Quality of Life
Sputum
Female
medicine.symptom
Infection
business
Zdroj: Journal of Cystic Fibrosis
ISSN: 1569-1993
Popis: Background Pulmonary exacerbations (PEx) in children with cystic fibrosis (CF) are frequently treated in the outpatient setting with oral antibiotics. However, little is known about the characteristics of PEx managed on an outpatient basis and the effectiveness of oral antibiotic therapy. We sought to prospectively evaluate clinical and laboratory changes associated with oral antibiotic treatment for PEx. Methods Children with CF between 8 and 18 years of age prescribed two weeks of oral antibiotics for a PEx were eligible to enroll. The study consisted of a visit within 48 h of starting antibiotics and a second visit within one week of antibiotic completion. Twenty-eight participants were evaluated by exacerbation score, quality of life measurements, lung function, sputum microbiology and inflammation. Results Oral antibiotic treatment was associated with a significant improvement in exacerbation score and quality of life measured by the CF Questionnaire-Revised (CFQ-R) respiratory domain. Following treatment, forced expiratory volume in 1 s (FEV1) % predicted increased [median (range)] 9% (−8%, 31%), and 22 (81%) subjects returned to 90% or higher of baseline FEV1. Bacterial density of the primary organism identified on sputum culture decreased significantly with a median (range) decrease of 0.8 log10 cfu/mL (−8 log10, 2 log10, p = 0.03). Sputum neutrophil elastase [−37 μg/mL (−464, 272), p = 0.02] and IL-1β [−2.8 × 103μg/mL (−6.9 × 104, 3.3 × 104), p = 0.03] decreased significantly following treatment in this cohort. Conclusions Treatment of PEx with oral antibiotics was associated with measurable improvements in patient reported outcomes, lung function, bacterial density and sputum inflammatory markers.
Databáze: OpenAIRE
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