title: Association between the introduction of a new cystic fibrosis inhaled antibiotic class and change in prevalence of patients receiving multiple inhaled antibiotic classes.
abstract: BACKGROUND
  In 2010, aztreonam for inhalation solution joined aminoglycosides and colistimethate as a new cystic fibrosis (CF) chronic inhaled antimicrobial therapy. We studied how the introduction of this new inhaled antibiotic class changed the management of US CF patients.
  
  
  METHODS
  The use of inhaled aminoglycosides, colistimethate, and aztreonam among patients followed in the CF Foundation Patient Registry was analyzed by age group, lung disease stage, and microbiologic status both annually, and at individual visits between 2009 and 2012.
  
  
  RESULTS
  The overall prevalence of inhaled antibiotic use did not change during the period, but the prevalence of annual and any visit treatment with >1 inhaled antibiotic class more than doubled. Adults, those with advanced lung disease, and those with >1 Pseudomonas aeruginosa respiratory culture were more likely to receive >1 antibiotic class.
  
  
  CONCLUSIONS
  Inhaled antibiotic management of US CF patients has dramatically changed in association with the introduction of a third inhaled antibiotic class.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, United States; Rainbow Babies and Children's Hospital, Cleveland, OH, United States. Electronic address: elliott.dasenbrook@case.edu.
authors.forename: Elliott C
authors.initials: EC
authors.lastname: Dasenbrook
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, United States; Rainbow Babies and Children's Hospital, Cleveland, OH, United States. Electronic address: michael.konstan@case.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Konstan
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, United States; Rainbow Babies and Children's Hospital, Cleveland, OH, United States. Electronic address: drv15@case.edu.
authors.forename: Donald R
authors.initials: DR
authors.lastname: VanDevanter
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001398:Aztreonam / Q000008:administration & dosage; D002648:Child; D003091:Colistin / Q000008:administration & dosage / Q000031:analogs & derivatives; D003550:Cystic Fibrosis / Q000150:complications* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012189:Retrospective Studies; D014031:Tobramycin / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000336:Aerosols; D000900:Anti-Bacterial Agents; C004691:colistinmethanesulfonic acid; D001398:Aztreonam; D014031:Tobramycin; D003091:Colistin
keywords: Cystic fibrosis; Inhaled antibiotics; Observational research; Patient registry; Pseudomonas aeruginosa