[Aerosol therapy and cystic fibrosis: a national survey]

Aerosol therapy in cystic fibrosis is indicated in order to administer active agents directly into the diseased organ. The practical application of this technique often remains a question of personal experience rather than rigorous and validated schemes. In order to determine the experience of those using this technique, a questionnaire was prepared by the health care centers certified by the French association against cystic fibrosis (65 centers). There were 53 responses (82%) covering 3400 patients. Two-thirds of these patients (2250) used nebulizers. Drugs used by order of frequency were: rhDNase (52 centers), antibiotics (51), conventional fluidifying agents (17), isotonic saline solution (14). Bronchodilators were used as sprays or inhalation chambers. Antibiotics most frequently prescribed were: colimycin (51 centers, doses 500.000 to 3 MIU per aerosol), tobramycin (44 centers, 25 to 600 mg per aerosol), amikacine (7 centers, 150 mg to 1.5 g per aerosol). Indications were mainly chronic colonization with Pseudomonas aeruginosa (39/53 centers) and episodes of bronchial superinfection with Pseudomonas aeruginosa (18/53 centers). Equipment maintenance appeared as the main problem in most centers (daily or more cleaning with antiseptic solutions in 46/53 centers). The differences in indications and dosages prescribed justify further prospective randomized studies to optimize treatment.