Home and hospital antibiotic treatment prove similarly effective in cystic fibrosis

Abstract

Background: Home intravenous antibiotic treatment has added to therapeutic options against Pseudomonas aeruginosa in cystic fibrosis (CF) patients leading to increased flexibility. A prospective clinical study was carried out to compare home and hospital iv antibiotic treatment in CF patients with chronic P. aeruginosa infection.

Patients and methods: Treatment courses were planned selectively, exacerbations were excluded. 28 consecutive hospital courses (group 1) were compared with 30 home care courses (group 2). Chest physiotherapy and nutrition therapy were carried on in both groups. Antibiotic treatment in both groups consisted of tobramycin and ceftazidime, with equal dosage and application. Groups were compared using clinical, inflammatory and microbiological parameters.

Results: There was a significant difference (p </= 0.05) in peripheral leukocyte counts before and after therapy in both groups. The same was true for forced expiratory volume in 1 sec (FEV(1); p </= 0.05), weight for height (p </= 0.005) and for Pseudomonas counts (p </= 0.005) in sputa. There was no statistical difference between the two groups for any of the parameters tested.

Conclusion: It is concluded that, when exacerbations are excluded, home iv therapy is an effective therapeutic option in CF. Long-term comparison is still needed to effectively evaluate the pros and cons of home and hospital antibiotic treatment in CF.