08 Nov Cystic Fibrosis Patients May Need Higher Doses of Antibiotics To Clear Lung Infections
MedicalResearch.com Interview with:
Andrea Hahn, M.D., MS
Infectious disease specialist and lead study author
Children’s National Health System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: People who have the genetic disease cystic fibrosis have increased sticky secretions in their lungs that put them at risk for repeated bacterial infections. They often will receive courses of intravenous antibiotics to treat more severe or difficult-to-treat infections associated with decreased lung function. However, not all patients fully recover their lung function after antibiotic treatment, despite directing antibiotic therapy toward the specific bacteria thought to be causing the infection. The goal of this study was to determine if the pharmacokinetics of commonly used antibiotics was associated with recovery of lung function.
First, we found that patients with therapeutic blood levels of beta-lactam antibiotics had better lung recovery than patients with sub-therapeutic levels of these antibiotics.
Second, we found that using higher antibiotic dosing according to Cystic Fibrosis Foundation guidelines was not sufficient to predict which patients would have therapeutically meaningful blood levels of antibiotics.
MedicalResearch.com: What should readers take away from your report?
Response: Simply choosing the right dose of antibiotics to treat a lung infection may not be enough to ensure that patients with cystic fibrosis are able to regain their baseline lung function. Instead, it may be necessary to check blood levels of beta-lactam antibiotics or use pharmacokinetic modeling programs to appropriately dose these antibiotics.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future studies that incorporate the use of real-time therapeutic drug monitoring or pharmacokinetic modeling to adjust beta-lactam doses and evaluate their effect on lung function would help determine if these techniques should be incorporated into routine clinical practice.
MedicalResearch.com: Is there anything else you would like to add?
Response: This study was funded in part by a career development award (K12) from the NIH National Heart, Lung, and Blood Institute, the Second President’s Award for Innovative Research from Children’s Research Institute at Children’s National Health System, the Clinical and Translational Science Institute at Children’s National which is supported by the NIH National Center for Advancing Translational Sciences
Andrea Hahn, Caroline Jensen, Hani Fanous, Hollis Chaney, Iman Sami, Geovanny F. Perez, Stan Louie, Anastassios C. Koumbourlis, James E. Bost, John N. van den Anker. Relationship of Pulmonary Outcomes, Microbiology, and Serum Antibiotic Concentrations in Cystic Fibrosis Patients. The Journal of Pediatric Pharmacology and Therapeutics, 2018; 23 (5): 379 DOI: 10.5863/1551-6776-23.5.379
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