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Change of antibiotic is not associated with improved expiratory volume response in patients with fib

Although advances in treatment lead to improvements in care, change does not reflect changes in the patient.

Pulmonary exacerbation is defined as increased signs and symptoms and increased airway secretion. Photo: Shutterstock.

Recent research has shown that changing antibiotics during treatment in patients with pulmonary exacerbations and cystic fibrosis Improved forced respiration with poor clinical response was not associated with lung volume response or return to baseline lung function. He specified that the aim was to characterize the effect of the change of directed antibiotics. cystic fibrosisand thus be able to examine the effects of changes in antibiotics on the recovery of lung function. This was a retrospective cohort study using the database of cystic fibrosis Pulmonary excitation in Toronto adults and children between the period 2009 to 2015 and cystic fibrosis Treated with intravenous antibiotics. “The co-primary outcome measure was the absolute and relative change in forced expiratory lung volume in 1 s at the end of treatment and follow-up. The secondary outcome assessed the proportion of patients who had a previous initial forced expiratory lung volume in 1 s. returned 90% or >100%. Among the results, it was found that out of a total of 399 patients treated for pulmonary embolism, 105 had antibiotic changes.

Reasons for antibiotic changes included antibiotic route changes before discharge (26%), drug response (20%), poor response to forced expiratory lung volume in 1 second (25%), detection of additional microbes (16%) and Includes a lack of symptoms. improvement (13%).

“In short, change of antibiotic In non-responders it was not associated with a 90% or 100% baseline forced expiratory lung volume improvement in 1 s at the end of treatment or follow-up.

Cystic fibrosis and pulmonary exacerbation

cystic fibrosis It is a potentially fatal congenital disease, and according to medical literature records it is more common in the white population.

The disease is transmitted in an autosomal recessive manner, and is characterized by dysfunction of the exocrine glands, producing an unusually thick secretion, with hydroelectrolytic and mucoprotein changes.

Clinical manifestations are secondary to obstruction of the affected organs, primarily the lungs, pancreas, intestine, liver, biliary tract and genitals. Infectious exacerbations are the leading cause of mortality cystic fibrosis,

On the other hand, pulmonary excitability is defined as increased signs and symptoms and airway secretions; And there are clinical, radiographic, spirometric and laboratory criteria for the diagnosis of an exacerbation.

In affected patients, exacerbation and admission increase from the second decade of life. Patient age will be closely related to various possibilities of colonization or infection, and gradual control of respiratory secretions is essential to assess the type of treatment to be performed.

Once chronic infection is established, which is incurable, the goal of therapy is not to obtain negative cultures, but to reduce the number of colonies as much as possible to maintain stable lung function and avoid exacerbation. Is.

Danish experience in the 1980s using intravenous therapy for 14 days with beta-lactams and an aminoglycoside, alternately hospitalizing the patient every 3 months, showed very good results, apparently for patients. Quality of life and quality of life improved.

Currently, this regimen has been replaced and exceeded with available inhaled antibiotics, which allow long-term treatment, in high doses, with minimal toxicity and with excellent quality of life. When performed on an outpatient basis and without changing the patient’s normal school or work activity.

Access the study here.



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