Abstract
Background
This retrospective audit was undertaken to compare the efficacy of home intravenous (IV) antibiotic therapy, hospital IV antibiotic therapy and a combination of these 2 approaches, as determined by spirometric measures of lung function in cystic fibrosis (CF) patients, each with an acute respiratory exacerbation.
Methods
Pulmonary function, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow rate between 25 per cent and 75 per cent of vital capacity (FEF25–75), and peak expiratory flow rate (PEFR) were compared between groups at the beginning and at the end of an IV antibiotic course.
Results
Treatment of exacerbations resulted in a significant improvement (p<0.05) in lung function irrespective of where patients were treated. The percentage improvement in FEV1, FVC, and FEF25–75, were significantly greater in patients treated in hospital compared to those who had home IV treatment (p<0.05).
Conclusion
Hospital IV antibiotic therapy resulted in greater improvements in FEV1, FVC and FEF25–75 than home IV antibiotic therapy in CF patients with an acute respiratory infection.
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References
Elborn, J. S., Shale, D. J., Britton, J. R. Cystic fibrosis: Current survival and population estimates to the year 2000. Thorax 1991; 46: 881–5.
Smith, A. L. Antibiotic therapy in cystic fibrosis. Evaluation of clinical trials. J. Pediatr. 1986; 108: 866–70.
Gilbert, J., Robinson, T., Littlewood, J. M. Home intravenous antibiotic treatment in cystic fibrosis. Arch Dis. Child. 1988; 63: 512–7.
Donati, M. A., Guenette, G., Auerbach, H. Prospective controlled study of home and hospital therapy of cystic fibrosis pulmonary disease. J. Pediatr. 1987; 111: 28–33.
Kuzembo, J. A. Home treatment of pulmonary infections in cystic fibrosis. Chest 1988; 94: 5162–6.
Martinez, M. A., Votoroubek, M. Efficiency of respiratory home treatment versus impatient care for CF patients. Am. Rev. Respir. Dis. 1987; 135: 162s-5s.
Pond, M. N., Newport, M., Joanes, D., Conway, S. P. Home versus hospital intravenous antibiotic therapy in the treatment of young adults with cystic fibrosis. Eur. Respir. J. 1994; 7: 1640–4.
Strandvik, B., Hjelte, L., Malmborg, A. S., Widen, B. Home intravenous antibiotic treatment of patients with cystic fibrosis. Acta Paediatr. 1992; 81: 340–4.
Winter, R. J. D., George, R. J. D., Deadcock, S. J., Shee, C. D. Self administered home intravenous antibiotic therapy in bronchiectasis and adult cystic fibrosis. Lancet 1984; 1: 1338–9.
Wolter, J. M., Bowler, S. D., Nolan, P. J., McCormack. Home intravenous therapy in cystic fibrosis: a prospective randomised trial examining clinical quality of life and cost aspects. Eur. Respir. J. 1997; 10: 896–900.
Hammond, L. J., Caldwell, S., Campbell, P. W. Cystic fibrosis, antibiotics and home therapy. J. Pediatr. Health Care 1991; 5: 24–30.
Abbot, J., Dodd, M., Bilton, D., Webb, A. K. Treatment compliance in adults with cystic fibrosis. Thorax 1994; 2: 115–20.
Alison, J. A., Donnelly, P. M., Lennon, M. et al. The effect of a comprehensive inpatient treatment programme on lung function and exercise capacity in patients with cystic fibrosis. Phys. Ther. 1994; 74: 583–93.
Gozal, D., Bailey, S. L., Keens, T. G. Evaluation of pulmonary function during an acute exacerbation in hospitalised patients with cystic fibrosis. Pediatr. Pulmonol. 1993; 16: 347–53.
Corey, M., Levison, H., Corzier, D. Five to seven year course of pulmonary function in cystic fibrosis. Am. Rev. Respir. Dis. 1976; 114: 1085–92.
Taussig, L. M., Landau, L. I., Marks, M. I. Respiratory system. In: Taussig, L. M., ed. Cystic fibrosis. New York: Theime-Stratton, 1984; 115–1175.
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Bradley, J.M., Wallace, E.S., Elborn, J.S. et al. An audit of the effect of intravenous antibiotic treatment on spirometric measures of pulmonary function in cystic fibrosis. Ir. J. Med. Sc. 168, 25–28 (1999). https://doi.org/10.1007/BF02939576
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DOI: https://doi.org/10.1007/BF02939576