Highlights
- •AET successfully clears Pseudomonas aeruginosa in most individuals.
- •Whether this translate in clinical benefits is less clear.
- •Eradication of Pseudomonas aeruginosa improves lung function trajectories.
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.
Methods
CF patients who were P. 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 P. aeruginosa isolated from a respiratory tract sample. Subjects changed to the Eradicated group
if they had a P. aeruginosa infection, were treated with AET, and subsequently cleared their infection. Subjects
changed to the Chronic group if AET did not clear their P. 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.
Results
205 CF subjects (48% 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 P. 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).
Conclusions
AET against P. aeruginosa improves lung function trajectory in CF patients.
Keywords
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Article info
Publication history
Published online: August 19, 2022
Accepted:
August 10,
2022
Received in revised form:
August 10,
2022
Received:
March 24,
2022
Identification
Copyright
© 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
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Access this article on ScienceDirectLinked Article
- In the Clear: Long-term pulmonary function benefits associated with Pseudomonas aeruginosa eradicationJournal of Cystic FibrosisVol. 22Issue 1
- PreviewDespite significant improvements in life expectancy for individuals with cystic fibrosis (CF) over the last two decades, CF continues to be a life-shortening disorder characterized by progressive, obstructive lung disease associated with chronic airway infection, inflammation, and parenchymal damage. Abnormal ion transport in the CF airways and altered antimicrobial airway defenses result in persistent infections with pathogens such as Pseudomonas aeruginosa. Although the progression of CF lung disease is impacted by many factors, P.
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