Background

Several clinical guidelines recommend chronic inhaled therapy for pwCF (people with cystic fibrosis) and chronic Pseudomonas aeruginosa infection of the lungs.

Methods

To demonstrate what kind of therapy regimens are used in Germany, we retrospectively analysed chronic inhaled antibiotic therapy within the cohort of the German CF Registry in 2020. For comparison we also analysed the use of inhaled antibiotics in pwCF with intermittent Pseudomonas or without Pseudomonas infection.

Results

A total of 1960 pwCF had chronic P. aeruginosa infection and were retrospectively evaluated. Almost 90% (n = 1751) received at least one inhaled antibiotic. The most commonly used inhaled antibiotic was colistin solution for inhalation (55.2%), followed by aztreonam solution for inhalation (32.6%) and tobramycin solution for Inhalation (30%). Almost 56% of adults and 44% of children alternated two antibiotics for inhalation. In children, alternating colistin + tobramycin was the most often used regimen. In adults, only 23% used colistin + tobramycin; there was a wide range of treatment regimens among adults using two inhaled antibiotics alternately. 2456 pwCF had no Pseudomonas infection, but almost 24% had a chronic inhaled antibiotic therapy, while 56% of 361 pwCF and intermittent chronic Pseudomonas infection had a chronic inhaled antibiotic therapy.

Conclusion

In all three groups the most commonly used inhaled antibiotic was colistin solution for inhalation. Almost 56% of adults and 44% of children with chronic Pseudomonas infection alternated two antibiotics for inhalation. It will be interesting to see how the introduction of the highly effective modulator elexacaftor/tezacaftor/ivacaftor will change the use of inhaled antibiotics.

中文翻译：

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德国铜绿假单胞菌感染囊性纤维化患者的慢性吸入性抗生素治疗

背景

几项临床指南建议对 pwCF（患有囊性纤维化的人）和肺部慢性铜绿假单胞菌感染进行慢性吸入治疗。

方法

为了证明德国使用哪种治疗方案，我们回顾性分析了 2020 年德国 CF 登记队列中的慢性吸入抗生素治疗。为了进行比较，我们还分析了间歇性假单胞菌感染或无假单胞菌感染的 pwCF 中吸入抗生素的使用情况。

结果

共有 1960 名 pwCF 患有慢性铜绿假单胞菌感染，并进行了回顾性评估。几乎 90% (n = 1751) 接受了至少一种吸入抗生素。最常用的吸入抗生素是吸入用粘菌素溶液（55.2%），其次是吸入用氨曲南溶液（32.6%）和妥布霉素吸入溶液 (30%)。几乎 56% 的成年人和 44% 的儿童交替吸入两种抗生素。在儿童中，交替使用多粘菌素 + 妥布霉素是最常用的方案。在成人中，只有 23% 使用粘菌素 + 妥布霉素；交替使用两种吸入抗生素的成年人有多种治疗方案。2456 pwCF 没有假单胞菌感染，但近 24% 接受了慢性吸入抗生素治疗，而 361 pwCF 和间歇性慢性假单胞菌感染中有 56% 接受了慢性吸入抗生素治疗。

结论

在所有三组中，最常用的吸入抗生素是吸入用粘菌素溶液。几乎 56% 的成人和 44% 的慢性假单胞菌感染儿童交替吸入两种抗生素。看看高效调节剂 elexacaftor/tezacaftor/ivacaftor 的引入将如何改变吸入抗生素的使用将会很有趣。