Early pseudomonas aeruginosa treatment and long term lung function in pediatric cystic fibrosis

Abstract

Introduction: While antibiotic eradication therapy (AET) of early Pseudomonas aeruginosa infection is considered standard of care, its long-term effect on the subsequent course of cystic fibrosis (CF) lung disease remains unclear. \nMethods: CF patients who were Pseudomonas aeruginosa-free for at least a year and had a minimum of 10 years of pulmonary function measurements were included. Subjects were categorized as Never if they never had Pseudomonas aeruginosa isolated from a respiratory tract sample. Subjects changed to the Eradicated group if they had a Pseudomonas aeruginosa infection, were treated with AET, and subsequently cleared their infection. Subjects changed to the Chronic group if AET did not clear their Pseudomonas aeruginosa infection. The primary outcome was absolute FEV1 decline over time, with age as the time variable. Mixed-effects linear regression models were used to account for the repeated lung function measurements over time within each patient. \nResults: 205 CF subjects (48% were female) were included; the median (IQR) age at first infection was 9. 6 (5. 6, 14. 6) years. The median (IQR) follow-up was 10. 2 (5. 7, 14. 7) years for the Eradicated group, 8. 8 (4. 5, 14. 9) years for the Chronic group and 2. 8 (1. 0, 5. 7) years for the Never group was among those patients that had at least one Pseudomonas aeruginosa infection over the study period, annual lung function decline of FEV1 was significantly less (-1. 11% predicted/year; 95% CI: -1. 18, -1. 04) in the Eradication group compared to the Chronic group (-1. 57%; -1. 64, -1. 50) (p<0. 001). \nConclusions: AET against Pseudomonas aeruginosa improves lung function trajectory in CF patients.

Date of Award	10 Mar 2023
Original language	English
Supervisor	Montserrat Bosque Garcia (Director)