title: The effect of early Pseudomonas aeruginosa treatment on lung function in pediatric cystic fibrosis.
abstract: OBJECTIVE
  Our aim was to assess the effect of treatment of early infection of P. aeruginosa on pulmonary function in pediatric CF patients.
  
  
  METHODS
  This was a retrospective cohort study of P. aeruginosa negative CF patients followed at Sick Kids from 1990 to 2007. Early P. aeruginosa infection was defined as the first respiratory culture for P. aeruginosa; patients were included if 5 years of follow-up pulmonary function data were available. Patients were divided into three groups (group 1: never infected, group 2: infected with subsequent clearance, and group 3: chronic infection or still receiving antipseudomonal antibiotics). Hierarchical linear models were used to estimate the effect of P. aeruginosa infection on spirometry. FEV(1) % predicted was the primary outcome.
  
  
  RESULTS
  116 patients were included. Forty-six (40%) patients remained P. aeruginosa negative throughout the observation period, 29 (25%) patients transiently infected with P. aeruginosa, and 41 (35%) patients were either currently infected or still receiving treatment. Baseline lung function was the same for all groups. Annual decline in FEV(1) % predicted during the study period was not different (-0.6%/year for patients that were never infected and -1.3%/year among patients previously infected).
  
  
  CONCLUSIONS
  Lung function was not different between patients with early P. aeruginosa infection and those that never had P. aeruginosa infection. However given the slow rate of FEV(1) decline in the study population, a longer observation period and/or more sensitive outcomes measures may be required to exclude long-term detrimental effects of transient P. aeruginosa infection on lung function in CF patients.
authors.affiliation: Division of Respiratory Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada. reshma.amin@sickkids.ca
authors.forename: Reshma
authors.initials: R
authors.lastname: Amin
authors.forename: Michelle
authors.initials: M
authors.lastname: Lam
authors.forename: Annie
authors.initials: A
authors.lastname: Dupuis
authors.forename: Felix
authors.initials: F
authors.lastname: Ratjen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D011550:Pseudomonas aeruginosa; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D012189:Retrospective Studies; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents