Cystic fibrosis

One size does not fit all for IV antibiotic duration


ECFS delegates voted a resounding ‘NO’ during a head to head debate on whether the duration of IV antibiotics should be 14 days for all cystic fibrosis patients.

Leading a very convincing ‘NO’ debate Barry Plant from Cork in Ireland noted that there were no clear guidelines on the optimum duration of IV antibiotic treatment.

A  Cochrane review presented at the meeting highlighted that in essence the data wasn’t there at the moment, he told delegates.

This was further illustrated by the Cystic Fibrosis Trust guidelines which “hedged its bets” by recommending 10-14 days duration, while noting that shorter courses may lead to exacerbations sooner.

“So what you can see is a huge variability… there’s no consensus,” he said.

“For me you’ve got to customise but the million dollar question is how are we going to?” he asked the audience.

Patrick Flume from Charleston in the US who led the ‘Yes’ debate suggested taking a starting point of 14 as a line in the sand, Cork noted.

“But I’d say we can do it through different ways… by using new technologies.”

“We should look at culture dependent vs culture independent approaches, at best combinations of antibiotics…We could also look at microbial activities and functions as well as augmenting therapy,” he said.

“We should move on with personalised care as one size does not fit all,” he concluded.

The audience agreed, with 84.4% voting for a personalised approach.

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