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Pulmonary function in infants with cystic fibrosis: the effect of antibiotic treatment
C S Beardsmore1, J R Thompson, A Williams
1Department of Child Health, University of Leicester, Leicester Royal Infirmary.
Insights
This study on antibiotic prophylaxis for cystic fibrosis (CF) in infants found no significant difference in respiratory function between continuous antibiotic treatment and on-demand antibiotics. Early CF diagnosis and monitoring are crucial.
Area of Science:
- Pediatric Pulmonology
- Clinical Trials
- Infectious Disease Management
Background:
- Cystic fibrosis (CF) screening has been standard for infants in the East Anglian Region since 1982.
- Antibiotic prophylaxis is a common strategy to prevent respiratory infections in infants with CF.
Purpose of the Study:
- To evaluate the efficacy of continuous oral flucloxacillin versus on-demand antibiotic treatment in infants with cystic fibrosis.
- To assess the impact of antibiotic prophylaxis on respiratory function in early childhood.
Main Methods:
- A randomized prospective controlled trial involving infants diagnosed with CF.
- Respiratory function tests, including thoracic gas volume and airway conductance, were performed at 3-4 months and 1 year of age.
- Measurements utilized infant whole body plethysmography and the 'squeeze' technique for expiratory flow.
Main Results:
- No significant differences in respiratory function scores were observed between the continuous antibiotic prophylaxis group and the on-demand antibiotic group at either assessment age.
- Mean respiratory function scores for both groups remained within normal limits.
- A general reduction in airway conductance was noted between the two testing periods across all infants.
Conclusions:
- Continuous oral flucloxacillin prophylaxis does not show a significant advantage over on-demand antibiotic treatment for respiratory outcomes in infants with cystic fibrosis.
- Further research may be needed to optimize antibiotic strategies for managing CF in infancy.
- Early detection through newborn screening allows for timely intervention and monitoring of respiratory health in CF patients.
Abstract:
Since 1982 all infants born within the East Anglian Regional Health Authority have been screened for cystic fibrosis. Between April 1985 and April 1992 infants identified in this way have been entered into a randomised prospective controlled trial of antibiotic prophylaxis. Approximately half the infants received continuous oral flucloxacillin and the remainder received antibiotics when clinically indicated. Infants underwent tests of respiratory function at 3-4 months and at 1 year of age. Measurements of thoracic gas volume and airway conductance were made with an infant whole body plethysmograph, and maximum expiratory flow by the 'squeeze' technique. A total of 73 tests was performed of 42 infants. To facilitate comparisons, measurements were expressed as scores. The mean values of the scores for the two groups of infants fell within normal limits. There was no difference between the treatment groups at either age. A reduction in airways conductance was observed between the two tests.