Implementation of European standards of care for cystic fibrosis--control and treatment of infection.
BACKGROUND
Several guidelines on infection control and treatment of infection exist for cystic fibrosis (CF) caregivers, although the extent of implementation is variable.


METHODS
Adherence to European Consensus Guidelines for CF was studied by sending surveys to named healthcare professionals in 487 European CF centres/units. Qualitative data analysis was performed.


RESULTS
A total of 177/547 (32%) surveys were returned. Infection control policies were implemented by most (77%) respondents. Separation of patients with Burkholderia cepacia was more common in adults (95%) than children (9%), and was implemented by 53% of respondents for Pseudomonas aeruginosa. Nebulised colistin plus oral ciprofloxacin was the most common (43%) therapy for P. aeruginosa infection. First infections of P. aeruginosa were usually treated with inhaled tobramycin; 41% of repondents did not intervene until lung function deteriorated. Most exacerbations were treated for less than the recommended period.


CONCLUSIONS
European Consensus Guidelines are widely adhered to. Areas for improvement include: initiating therapy for exacerbations early, separating infected patients and optimising duration of antibiotic therapy.
Elborn
J S
JS
Respiratory Medicine Research Group, Queen's University, Belfast City Hospital, Ground Floor, Lisburn Rd, Belfast, BT9 7AB, UK. stuart.elborn@bch.n-i.nhs.uk
Hodson
M
M
Bertram
C
C
D000280:Administration, Inhalation; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001424:Bacterial Infections / Q000188:drug therapy*; D019121:Burkholderia Infections / Q000188:drug therapy / Q000382:microbiology; D016956:Burkholderia cepacia; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000008:administration & dosage; D003091:Colistin / Q000008:administration & dosage; D003550:Cystic Fibrosis / Q000150:complications* / Q000628:therapy*; D005060:Europe; D019983:Guideline Adherence; D006801:Humans; D017053:Infection Control / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D011795:Surveys and Questionnaires; D014031:Tobramycin / Q000008:administration & dosage; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D014031:Tobramycin; D003091:Colistin