Home and hospital antibiotic treatment prove similarly effective in cystic fibrosis.
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.


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.


CONCLUSIONS
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.
Riethmueller
J
J
University Children's Hospital, Hoppe-Seyler-Str. 1, D-72076 Tuebingen, Germany. joachim.riethmueller@med.uni-tuebingen.de
Busch
A
A
Damm
V
V
Ziebach
R
R
Stern
M
M
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D018718:Home Infusion Therapy; D006761:Hospitals; D006801:Humans; D007262:Infusions, Intravenous; D011446:Prospective Studies; D011549:Pseudomonas / Q000302:isolation & purification
D000900:Anti-Bacterial Agents