title: Impact of intravenous antibiotic therapy on total daily energy expenditure and physical activity in cystic fibrosis children with Pseudomonas aeruginosa pulmonary exacerbation.
abstract: Resting energy expenditure (REE) increases during pulmonary exacerbation by Pseudomonas aeruginosa in cystic fibrosis (CF) patients, and decreases after i.v. anti-Pseudomonas aeruginosa antibiotic therapy (IVAT). However, the impact of IVAT on total energy expenditure (TEE) is unknown. The aim of this study was to assess the changes in TEE and its main components after IVAT administered at home. Body composition measured by skinfold thickness and bio-impedance analysis, energy intake (EI) assessed by a weekly diary, REE measured by indirect calorimetry (IC), TEE assessed by a technique using 24-h heart-rate monitoring method and physical activity (PA) monitored using an activity diary (AD) were assessed in 16 patients (9 boys and 7 girls) aged 12.1 +/- 2.3 y (range, 7.1-14.6 y), before and after 28 +/- 4 d including a 14-d IVAT course. After IVAT, weight increased significantly by 1.9% (32.1 +/- 7.5 versus 32.7 +/- 7.6 kg; p < 0.05), while fat mass and fat free mass increased non significantly. EI increased by 4.6% (10,797 +/- 3039 versus 11320 +/- 3074 kJ/d; p < 0.05). TEE was not affected by IVAT (7014 +/- 1929 versus 7081 +/- 1478 kJ/d) whereas REE decreased by 4.1% (5295 +/- 909 versus 5093 +/- 837 kJ/d; p < 0.05), resulting in 9.3% increase in PA assessed by AD converted to metabolic equivalent tasks (MET) (37.0 +/- 3.1 versus 40.7 +/- 4.5 MET; p < 0.05). The improvement in nutritional status after IVAT is not related to a decrease in TEE, but probably to an increase in EI and a decrease of REE after IVAT. After IVAT, the reduction in REE is probably compensated by an increase in PA in CF patients.
authors.affiliation: Unité de Gastroentérologie, Hépatologie et Nutrition, Clinique de Pédiatrie, Hôpital Jeanne de Flandre, 2, Avenue Oscar Lambret, 59037 Lille, France; fgottrand@chru-lille.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Béghin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
authors.forename: Laurent
authors.initials: L
authors.lastname: Michaud
authors.forename: Guy-Andre
authors.initials: GA
authors.lastname: Loeuille
authors.forename: Nathalie
authors.initials: N
authors.lastname: Wizla-Derambure
authors.forename: Ane
authors.initials: A
authors.lastname: Sardet
authors.forename: Dominique
authors.initials: D
authors.lastname: Guimber
authors.forename: Antoine
authors.initials: A
authors.lastname: Deschildre
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001823:Body Composition; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000378:metabolism*; D015930:Diet Records; D002149:Energy Intake; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents