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New clinical guidelines for exacerbations in cystic fibrosis
Date:10/22/2009

The American Thoracic Society has released new clinical guidelines for the treatment of exacerbations in cystic fibrosis based on a review of the literature on current clinical practices.

"This is the first such comprehensive and evidence-based systematic review of best practices for pulmonary exacerbation of cystic fibrosis," said Susanna McColley, M.D., head of the division of pulmonary medicine and director of the Cystic Fibrosis Center at Children's Memorial Hospital and associate professor at Northwestern University's Feinberg School of Medicine. "Until these, guidelines were arrived at by a less rigorous process based on the consensus of a committee of experts."

When cystic fibrosis patients suffer an acute exacerbation, they undergo an acute worsening of symptoms, which typically require medical intervention. While a prospective definition of an exacerbation has not yet been developed, clinical features are generally well-defined and represent a sharp deterioration in the general condition of the patient, often involving systemic symptoms such as weight loss and lack of appetite, as well as worsening of pulmonary symptoms such as cough, sputum production and shortness of breath. Exacerbations are the most common reason for hospitalization of cystic fibrosis patients.

The guidelines, which were presented at the North American Cystic Fibrosis Conference in October, highlighted a number of common practices in cystic fibrosis exacerbations.

The committee gave guidance on two areas of significant interest to clinicians: synergy testing and the dosing of aminoglycoside antibiotics. In the case of synergy testinga costly and time-consuming practice of determining what synergistic effects different antibiotics may have when used together against multi-drug resistant infectionswas found to have little benefit to the patient and the committee recommended against the routine use of it. In the case of aminoglycoside antibiotics,
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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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