According to the article by AAP, recommendations include:
- Attempt spirometry with children as young as 3 years.
- Perform chest radiographs at least every other year after diagnosis.
- Obtain oropharyngeal cultures to monitor respiratory microbiology at least quarterly.
- Use oral, inhaled or intravenous antibiotics to treat pulmonary exacerbations. Delivery method will depend on severity level.
- Use airway clearance therapy as maintenance treatment and encourage vigorous physical activity.
- Offer hypertonic saline or dornase alfa selectively for chronic use or acute pulmonary exacerbations based on individual circumstances.
- Do not use systemic and inhaled corticosteroids for routine CF care except to treat other issues like allergic bronchopulmonary aspergillosis. There was not enough evidence to make a recommendation on chronic use of inhaled bronchodilators.
- Provide interventions or specialty referral for those whose weight-for-age falls below the 10th percentile, body mass index falls below the 50th percentile or who exhibit challenging mealtime behaviors.
Read the full CPG here.
“The care of the preschool aged child with CF includes complex, time-consuming treatment regimens and overcoming behavioral challenges common in this age group to maintain lung health and optimize growth,” the authors concluded. “We hope that these guidelines will help CF care teams and families make informed decisions regarding care of the 2- to 5-year-old children with CF.”