title: Management of pulmonary exacerbations in cystic fibrosis: still an unmet medical need in clinical practice.
abstract: Pulmonary exacerbation (PEx) is a hallmark of cystic fibrosis. Although several criteria have been proposed for the definition of PEx, no consensus has yet been reached. Very often, many PEx cases go unreported. A standardized and validated definition is needed to reduce variability in clinical practice. The pathophysiology of recurrent episodes remains unclear, and both onset and risk are multifactorial. PEx leads to increased healthcare costs, impaired quality of life and a cycle in which PEx causes loss of lung function, which predisposes to further episodes. The number of episodes affects survival. Although early diagnosis and aggressive treatment are highly recommended, measures to prevent the emergence of new PEx are even more important. In particular, inhaled antibiotics administered under new treatment schedules could play a key role in preventing exacerbations and thus delay decline in lung function and reduce mortality. The primary objective is zero exacerbations.
authors.affiliation: Gilead - Respiratory Department, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Justicia
authors.forename: Amparo
authors.initials: A
authors.lastname: Solé
authors.forename: Esther
authors.initials: E
authors.lastname: Quintana-Gallego
authors.forename: Silvia
authors.initials: S
authors.lastname: Gartner
authors.forename: Javier
authors.initials: J
authors.lastname: de Gracia
authors.forename: Concepción
authors.initials: C
authors.lastname: Prados
authors.forename: Luis
authors.initials: L
authors.lastname: Máiz
mesh_terms: D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D006301:Health Services Needs and Demand; D006801:Humans; D020380:Needs Assessment; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: cystic fibrosis; inhaled antibiotics; prevention; prognosis; pulmonary exacerbations