Featured Research

from universities, journals, and other organizations

Home care equivalent to hospital care for some patients with cystic fibrosis, study finds

Date:
July 11, 2010
Source:
American Thoracic Society
Summary:
Patients with cystic fibrosis recover from exacerbations equally well if they are treated at home or in a hospital, according to researchers. Furthermore, longer treatment with antibiotics does not appear to offer any additional benefit over shorter courses.

Patients with cystic fibrosis (CF) recover from exacerbations equally well if they are treated at home or in a hospital, according to researchers from Johns Hopkins University. Furthermore, longer treatment with antibiotics does not appear to offer any additional benefit over shorter courses.

The study was published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

"We undertook this research owing to the lack of clinical information of best practices in treating CF exacerbations available to physicians," said J. Michael Collaco, M.D., assistant professor at Johns Hopkins.

In 2008 patients with CF had an average lifespan of only 37.4 years, and most died of the progressive pulmonary obstruction associated with the disease. The progression of the disease may be hastened by recurrent exacerbations.

"Traditional management includes aggressive airway clearance and antibiotics, the latter frequently administered intravenously, but despite effective symptomatic therapy, many patients may never completely recover their baseline lung function. Thus, it is crucial to determine the most effective means of therapy delivery for CF respiratory exacerbations," said Dr. Collaco. "Unfortunately, due to the difficulty of performing randomized controlled trials, existing evidence is insufficient for many treatment issues, including the best site for delivery of care and the optimal duration of therapy."

Outpatient intravenous antibiotic therapy has gained widespread acceptance because of its advantages over hospitalization including: fewer absences from school or work, less disruption of family life, decreased costs per treatment course, and high patient satisfaction. However, long-term costs may not be reduced in the outpatient setting if it precipitates the need for longer and more frequent courses of antibiotics, and quality of life may not always be better.

Dr. Collaco and colleagues from Johns Hopkins University used data from 1535 individuals in 755 families from the U.S. Cystic Fibrosis Twin-Sibling Study, a large, multi-center study directed by Garry Cutting, M.D., professor of genetics at Johns Hopkins. This analysis of the Twin-Sibling Study data compared levels of baseline lung function (forced expiratory volume in one second, or FEV1) to lung function at the end of treatment and over the year after treatment.

Dr. Collaco and colleagues found that exacerbations were followed by long-term declines in lung function regardless of whether antibiotics were administered in the hospital or at home, and no difference in intervals between courses of antibiotics was observed between hospital and home.

"This research indicates that intravenous antibiotic therapy for CF respiratory exacerbations administered in the hospital and in the home may be equivalent in terms of long-term FEV1 change and interval between courses of antibiotics," said Dr. Collaco. "Furthermore, we found that, based on improvement of FEV1, optimal duration of therapy may be seven to 10 days, as opposed to between 10 and 21 days, as is seen in current practice."

Patients who had a greater decline in lung function prior to starting therapy experienced steeper long-term declines following that course of therapy, indicating that more severe exacerbations have long-lasting effects, regardless of short-term treatment success. "This finding implies that patients with drastic drops in lung function with an exacerbation should be monitored more closely following treatment, for even with recovery of lung function, they remain at higher risk for greater long-term decline," said Dr. Collaco.

Dr. Collaco acknowledged that subjects participating in the Twin-Sibling Study may be more motivated than the general CF population, and thus may have increased compliance with antibiotics and chest physiotherapy when treated at home. These subjects are also members of families where more than one sibling has CF, thus these families may be more adept with home care, which could have biased the outcome toward the benefit of home therapy.

"Ultimately," he said, "given the decline in baseline FEV1 after an exacerbation, preventing exacerbations may be more important than the approach taken to treat the exacerbation. Taken together, our findings underscore the CF community's need for determining an optimal approach to the treatment of pulmonary exacerbations. Large prospective studies are needed to answer these essential questions for CF respiratory management."


Story Source:

The above story is based on materials provided by American Thoracic Society. Note: Materials may be edited for content and length.


Cite This Page:

American Thoracic Society. "Home care equivalent to hospital care for some patients with cystic fibrosis, study finds." ScienceDaily. ScienceDaily, 11 July 2010. <www.sciencedaily.com/releases/2010/07/100708071351.htm>.
American Thoracic Society. (2010, July 11). Home care equivalent to hospital care for some patients with cystic fibrosis, study finds. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2010/07/100708071351.htm
American Thoracic Society. "Home care equivalent to hospital care for some patients with cystic fibrosis, study finds." ScienceDaily. www.sciencedaily.com/releases/2010/07/100708071351.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Dangerous Bacteria Kills One in Florida

Dangerous Bacteria Kills One in Florida

AP (July 31, 2014) Sarasota County, Florida health officials have issued a warning against eating raw oysters and exposing open wounds to coastal and inland waters after a dangerous bacteria killed one person and made another sick. (July 31) Video provided by AP
Powered by NewsLook.com
Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Peace Corps Pulls Workers From W. Africa Over Ebola Fears

Peace Corps Pulls Workers From W. Africa Over Ebola Fears

Newsy (July 30, 2014) The Peace Corps is one of several U.S.-based organizations to pull workers out of West Africa because of the Ebola outbreak. Video provided by Newsy
Powered by NewsLook.com
Weather Kills 2K A Year, But Storms Aren't The Main Offender

Weather Kills 2K A Year, But Storms Aren't The Main Offender

Newsy (July 30, 2014) Health officials say 2,000 deaths occur each year in the U.S. due to weather, but it's excessive heat and cold that claim the most lives. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins