In:
Klinische Pädiatrie, Georg Thieme Verlag KG, Vol. 235, No. 02 ( 2023-03), p. 75-83
Abstract:
Background Pseudomonas aeruginosa (Pa) continues to affect disease
progression in cystic fibrosis (CF). However, the best eradication regimen remains unclear. This work compares three different antibiotic eradication
regimens in pediatric CF: an administration according to a standard-operating procedure (SOP) order vs. administration outside of this order (ooSOP). Methods This observational study includes all CF patients 〈 18 years
who received one of three Pa eradication treatments in the past eight years at our center: 1) inhaled high-dose tobramycin (Hi-TOBI), 2) inhaled
colistin+oral ciprofloxacin (COL/Cip), 3) inhaled low-dose tobramycin+4 intravenous 14-day Pa active antibiotic treatments
(lo-Tobra/IV). We compared eradication rates of the three treatment regimens performed according to the SOP-based order vs. ooSOP. Logistic
regression analysis was performed to identify risk factors for eradication failure. Results Performed according to SOP order, Hi-TOBI showed the greatest
efficacy, followed by lo-Tobra/IV and finally COL/Cip, while ooSOP lo-Tobra/IV was most successful, followed by COL/Cip and
Hi-TOBI. Previous Pa-infections and Pa-therapies along with age at CF diagnosis were risk factors for eradication failure. Conclusion Antibiotic treatment in SOP-based pre-defined order leads to
significantly better eradication rates than individual modifications of the order of administration. A short course of inhalational high-dose Tobramycin is
most successful at the first attempt. Prolonged antibiotic therapy seems to improve eradication after failed initial attempts.
Type of Medium:
Online Resource
ISSN:
0300-8630
,
1439-3824
Language:
English
Publisher:
Georg Thieme Verlag KG
Publication Date:
2023
detail.hit.zdb_id:
2039110-9
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