title: [Why do adults with mucoviscidosis refuse a medically recommended course of intravenous antibiotic therapy?].
abstract: BACKGROUND
  Regular courses of intravenous antibiotics are recommended for the treatment of chronic Pseudomonas aeruglnosa (PA) infection in patients with cystic fibrosis. We report the results of interviews performed to evaluate why a subgroup of patients vote against regular intravenous (i.v.) antibiotic treatment.
  
  
  METHODS
  Structured interviews covering a) the individual's perception of chronic PA infection, b) the patient's expectations regarding the effectiveness of i.v. treatment, c) the patient's personal reasons for refusal of i.v. treatment. STUDY COHORT: 16 out of 18 adult patients treated in the adult CF outpatient clinic at Hannover Medical School who had voted against the physician's recommendation to receive regular i.v. therapy twice a year.
  
  
  RESULTS
  More than one half of the patients did not regard chronic PA infection as important due to the lack of specific symptoms. A subgroup of patients had no idea of what their clinical status should be if i.v. antibiotics would be necessary; these patients reported prior experience of treatment courses which had been ineffective and had been instituted after talking into the patients. The most frequent reasons against IV treatment were not being sick enough and fear of adverse drug effects.
  
  
  RESULTS
  The results are being discussed considering the physician-patient relationship. The reasons why patients refuse help should be extensively explored rather than simply addressing this attitude as "non-compliance". Patients, too, come to reasonable decisions, and it is important to know their thoughts and reasoning if one intends to influence them.
authors.affiliation: Abt. Pneumologie, Medizinische Hochschule Hannover, Zentrum Innere Medizin und Dermatologie.
authors.forename: G
authors.initials: G
authors.lastname: Ullrich
authors.forename: C
authors.initials: C
authors.lastname: Smaczny
authors.forename: G
authors.initials: G
authors.lastname: Steinkamp
authors.forename: J
authors.initials: J
authors.lastname: Weber
authors.forename: T
authors.initials: T
authors.lastname: Welte
authors.forename: R
authors.initials: R
authors.lastname: Busse
authors.forename: T O
authors.initials: TO
authors.lastname: Wagner
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis / Q000523:psychology; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D007722:Health Knowledge, Attitudes, Practice; D018718:Home Infusion Therapy / Q000523:psychology; D006801:Humans; D007262:Infusions, Intravenous; D009894:Opportunistic Infections / Q000517:prevention & control / Q000523:psychology; D018410:Pneumonia, Bacterial / Q000517:prevention & control* / Q000523:psychology; D011552:Pseudomonas Infections / Q000517:prevention & control* / Q000523:psychology; D016312:Treatment Refusal