Nutritional impact of antipseudomonas intravenous antibiotic courses in cystic fibrosis.
OBJECTIVE
To evaluate the short term effects on nutritional status of home intravenous anti-pseudomonas antibiotic courses in cystic fibrosis (CF) patients chronically colonised with Pseudomonas aeruginosa.


METHODS
A prospective study involving 38 CF patients, mean age 10.9 (SD 4.3) years (range 4.3 to 22.2 years), presenting with pulmonary exacerbations of P aeruginosa infection. The patients received a 14 day antibiotic course of intravenous ceftazidime (200 mg/kg/day) and either amikacin (35 mg/kg/day) or tobramycin (15 mg/kg/day). Nutritional evaluation on days 1 and 14 involved measurements of weight, weight/height ratio (per cent of predicted value), energy intake (per cent of recommended daily allowances), serum prealbumin, and body composition assessed by two methods: bioelectrical analysis (BIA) and skinfold anthropometry. The non-parametric Wilcoxon t test was used for statistical analysis, with a Bland-Altman plot to assess the degree of agreement between the two methods of evaluating body composition.


RESULTS
Weight increased by 1.0 (0.8) kg (p < 0.001); weight/height increased from 94.4(12.2)% to 98(12.7)% (p < 0.001), energy intake from 107(32)% to 119(41)% (p < 0.02), and prealbumin from 183 (63) to 276 (89) mg/l (p < 0.001). Fat mass increased by 0.8 (1.0) kg (p < 0.001), without any significant change in fat-free mass. The limits of agreement between BIA and anthropometry were -0.7 kg and +1.1 kg.


CONCLUSIONS
Antibiotic courses allow an improvement in nutritional status in CF patients, with a gain in fat mass.
Vic
P
P
Department of Paediatrics, Lille University Hospital, France.
Ategbo
S
S
Gottrand
F
F
Launay
V
V
Loeuille
G A
GA
Elian
J C
JC
Druon
D
D
Farriaux
J P
JP
Turck
D
D
D000293:Adolescent; D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D000886:Anthropometry; D001823:Body Composition; D002442:Ceftazidime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy*; D014031:Tobramycin / Q000627:therapeutic use
D000583:Amikacin; D002442:Ceftazidime; D014031:Tobramycin