Cystic Fibrosis: Long-Term Antibiotics Not Needed in Patients Without Chronic P Aeruginosa

Outcomes don’t improve in cystic fibrosis patients given long-term inhaled antibiotics who do not have chronic Pseudomonas aeruginosa (PA), a new study found.

Practice guidelines recommend that people with CF receive chronic treatment with inhaled antibiotics if they are chronically infected with PA from the age of 6 years. However, many clinicians prescribe inhaled antibiotics for those with CF who do not have chronic PA infection, under the assumption that this may prevent reinfection with PA or improve outcomes of CF in others ways. In light of these practices, researchers sought to establish the prevalence of inhaled antibiotic use in people with CF without chronic PA infection. They also investigated long-term outcomes of inhaled antibiotic therapy.

The study was based on data from the European Cystic Fibrosis Patient Registry, a databank of information collected on people with CF since 2008, which now includes people from 39 European countries. A total of 7210 people with CF without chronic PA infection at baseline who were at least 6 years of age were included in the study; 37.75% (2722 of 7210) of these people were on long-term inhaled antibiotic therapy. Read more here.

Vitamins C and E for CF

More than 160,000 people around the world have cystic fibrosis, and supplementing with vitamins C and E could help reduce the damaging inflammation in their lungs, according to new research.

“Cystic fibrosis is a genetic disease that is associated with increased inflammation, and like many inflammatory diseases, it comes with a large amount of oxidative stress,” said Maret Traber, a professor at Oregon State College of Public Health and Human Sciences.

This new study looked at whether supplementing with high-dose vitamin C would help patients better absorb vitamin E. People with cystic fibrosis also have trouble with fat absorption. This can limit uptake of vitamin E, which is a fat-soluble antioxidant, said Traber.

“Low vitamin E levels plus high oxidative stress is a recipe for more inflammation, which can contribute to a range of negative health outcomes,” Traber said in a university news release.

Having difficulty with fat absorption means that patients need to consume more vitamin E, at least 400 milligrams daily to achieve normal blood concentrations, she added. Read more here.

Abnormal blood sugar levels in CF

People with cystic fibrosis (CF) who have abnormal glucose tolerance — higher-than-normal blood sugar levels after eating — are more likely to experience clinical exacerbations of worsening lung function, according to a new study.

This was found to be true even for patients who don’t meet the criteria for a diagnosis of cystic fibrosis-related diabetes (CFRD) — a common complication for people with CF.

Researchers found that determining abnormal blood sugar levels in CF patients through broader testing may help identify those at risk for exacerbations.

“Our study demonstrated that [such testing] … may predict increased incidence of [pulmonary exacerbations] in patients with CF,” the team wrote. Read more here.