Implementation of European standards of care for cystic fibrosis--control and treatment of infection

J Cyst Fibros. 2009 May;8(3):211-7. doi: 10.1016/j.jcf.2009.03.001. Epub 2009 Apr 16.

Abstract

Background: Several guidelines on infection control and treatment of infection exist for cystic fibrosis (CF) caregivers, although the extent of implementation is variable.

Methods: Adherence to European Consensus Guidelines for CF was studied by sending surveys to named healthcare professionals in 487 European CF centres/units. Qualitative data analysis was performed.

Results: A total of 177/547 (32%) surveys were returned. Infection control policies were implemented by most (77%) respondents. Separation of patients with Burkholderia cepacia was more common in adults (95%) than children (9%), and was implemented by 53% of respondents for Pseudomonas aeruginosa. Nebulised colistin plus oral ciprofloxacin was the most common (43%) therapy for P. aeruginosa infection. First infections of P. aeruginosa were usually treated with inhaled tobramycin; 41% of repondents did not intervene until lung function deteriorated. Most exacerbations were treated for less than the recommended period.

Conclusions: European Consensus Guidelines are widely adhered to. Areas for improvement include: initiating therapy for exacerbations early, separating infected patients and optimising duration of antibiotic therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Bacterial Infections / drug therapy*
  • Burkholderia Infections / drug therapy
  • Burkholderia Infections / microbiology
  • Burkholderia cepacia
  • Child
  • Child, Preschool
  • Ciprofloxacin / administration & dosage
  • Colistin / administration & dosage
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / therapy*
  • Europe
  • Guideline Adherence*
  • Humans
  • Infection Control / standards*
  • Practice Guidelines as Topic / standards*
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology
  • Surveys and Questionnaires
  • Tobramycin / administration & dosage
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Ciprofloxacin
  • Tobramycin
  • Colistin