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CF Exacerbations: Treatment Setting Matters

By David Lederer, MD, editor, Annals of the American Thoracic Society
Follow Dr. Lederer on Twitter @AnnalsATSEditor

Treatment Setting and Outcomes of Cystic Fibrosis Pulmonary Exacerbations

Pulmonary exacerbations in cystic fibrosis patients can lead to lung function loss, morbidity, and mortality, and yet, whether these exacerbations are better treated in an inpatient or outpatient setting is not known. In a February Annals of the American Thoracic Society article, Michael S. Schechter, MD, MPH, and co-authors report that after analyzing 4,497 pulmonary exacerbations in 2,773 patients, they found that inpatient intravenous antibiotic treatment was more effective.

Successful treatment was defined as percent predicted FEV1 ≥ 90 percent of baseline within 30 days after treatment. Overall about 75 percent of exacerbations in this study were successfully treated, with the researchers’ primary analytic model finding a 9 percent increment in successful treatment among inpatients. This association was true for adults and children, but the association was stronger in children. There was no relationship between the length of IV treatment and FEV1 recovery. 

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