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Anti-Pseudomonas antibiotics have previously been shown to improve nutritional status in patients with cystic fibrosis, although the exact mechanism for this is unclear. In this prospective study 16 children of mean age 12.1 years with cystic fibrosis and chronic Pseudomonas aeruginosa colonisation were studied during and after a pulmonary exacerbation. Before a 2 week course of home intravenous antibiotics, aspects of their energy intake and expenditure were measured and body composition analysed to derive fat and fat free masses. Energy intake was measured with detailed 1 week food records analysed by a dietician. Resting energy expenditure was calculated by measuring oxygen consumption and carbon dioxide production. Total energy expenditure was calculated using heart rate monitoring calibrated against indirect calorimetry and 24 hour diaries of physical activity were kept. These measures were repeated 5–10 days after the end of the antibiotic course.
Following antibiotic treatment, both energy intake and weight were increased by 1.9% and physical activity was increased by 9.3%. Total energy expenditure was similar before and after antibiotics. Resting energy expenditure increased during exacerbations with Pseudomonas aeruginosa and was significantly decreased by 4.1% after antibiotic treatment.
The authors suggest that an increase in weight and energy intake following antibiotic treatment directly promotes physical activity in children with cystic fibrosis and that this may have beneficial effects on their lifestyles.
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