Clinician variability in the diagnosis and treatment of aspergillus fumigatus-related conditions in cystic fibrosis: An international survey
| Autor: | Richard B. Moss, Gina Hong, Carsten Schwarz, Sameer Desai, Bradley S. Quon, Patience Eschenhagen |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Cystic Fibrosis Itraconazole Disease Cystic fibrosis Article Pulmonary function testing Aspergillus fumigatus Prednisone Surveys and Questionnaires Internal medicine medicine Aspergillosis Humans Practice Patterns Physicians' biology business.industry International survey medicine.disease biology.organism_classification Pediatrics Perinatology and Child Health Allergic bronchopulmonary aspergillosis business medicine.drug |
| Zdroj: | J Cyst Fibros |
| ISSN: | 1569-1993 |
| Popis: | Background The diagnosis and treatment of Aspergillus fumigatus (Af)-related conditions remain a challenge in cystic fibrosis (CF) due to overlapping features of disease and absence of clinical guidelines for Af-related conditions outside of ABPA. Objective To investigate the differences of clinical practice in the diagnosis and management of Af-related conditions in CF. Methods We conducted an international survey to CF clinicians to ascertain the screening, diagnostic, and treatment practices for Af-related conditions in CF. Respondents were grouped into geographical regions and regional comparisons using chi-square tests of independence or Fisher's tests were performed. Results A total of 319 survey responses from 35 countries were analyzed. We observed differences in use and frequency of fungus culture, Aspergillus-specific IgE and IgG, skin prick testing, and pulmonary function testing as screening for Af-related conditions between the geographical regions. ABPA and Aspergillus bronchitis diagnostic criteria selection differed by region; significantly greater proportion of United States (US) and Canadian clinicians were unable to define Aspergillus bronchitis compared to Europe and other regions. Decision to treat ABPA was uniform across regions, but the consideration of Aspergillus bronchitis as a clinical disease warranting therapy differed between regions. The use of glucocorticoid and itraconazole was the first-line treatment of ABPA among clinicians; however, prednisone monotherapy was more common in US and Canada. Conclusions Significant variability in the diagnosis and management of Aspergillus-related conditions in CF was observed. Future studies are necessary to better harmonize the approach to Af-related disease in CF. |
| Databáze: | OpenAIRE |
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