Children and young adults with cystic fibrosis (CF) whose lung infections were treated with antibiotic doses of antibiotics had reduced changes in the microbial lung variation during IV treatment, and their levels microbial diversity higher 30 days later, multi-institutional study that includes child researchers. In contrast, patients treated with therapeutic doses had decreased more in the lung microbial variety and many lower levels of lower variation when the antibiotic treatment came to an end as well as 30 days later.
"With the therapeutic treatment group, this could be a basement effect where it is harder to reduce diversity when it is already already low. Patients in the group also therapeutic disease higher than those in the therapeutic group, which could influence the findings, "explains Andrea Hahn, MD, MS, an infectious disease specialist in the Children's National Health System and lead author of the study.
The findings, published online February 22, 2019, in Scientific Reports, indicate the importance of the expression between baseline microbial diversity and the function of the lungs and has the potential to improve clinical practice, which & # 39; the research team writes.
More than 30,000 people in the United States live with CF, a genetic disease that leads to regular lung infections that slowly replace the lungs over time. People who suffer from this disease often require hospitals for these infections, known as aggravating lung pulmonary (APE), usually treated with antibiotics. These often contain beta-lactams, a class of antibiotics that include penicillin and a host of other compounds that are associated with a structure.
Exacerbation of the lung function among CF patients has been involved in reducing microbial variation in their lungs, a factor that is believed to be caused by the distribution of repetitive antibiotics to treat APEs. Although it is well-known that patients often do not achieve therapeutic doses of antibiotics that effectively cleans their infections, it is not clear how microbial variation changes in patients receiving lower doses -therapeutic compared to patients receiving therapeutic doses.
To investigate this question, Hahn and colleagues recruited 20 patients between 1 and 21 years old who were treated for APEs with beta-lactam antibiotics in National Children. For each patient, the researchers collected four samples of respiratory fluid:
– When the study participants were good
– Although they get an APE
– Immediately after the antibiotic course ends and
– Yet at least 30 days later.
They carried out all samples through genetic tests to determine the types of bacteria that are present and their relative abundance. The research team also collected blood samples from each patient while they followed their antibiotic courses, as well as data on their lung function.
The 20 patients received 31 antibiotic courses over the study period, which ended from March 2015 to August 2016. Hahn and colleagues found that only about 45 per cent of these courses were considered therapeutic , with blood concentrations of these drugs rising high enough to effectively treat their infections.
Hahn and colleagues suspect that patients who are often unable to achieve therapeutic blood levels of antibiotics are genetically preceded to the rapid metabolism of beta-lactam antibiotics. Repeat therapeutic antibiotics may significantly increase microcidal variation without clearing infections effectively, resulting in more lung damage that adversely affects the effect of lungs over time.
Hahn adds that it might be possible to avoid this effect ultimately by keeping closer tabs at patients of antibiotic blood patients in real time to ensure that all APEs are treated with therapeutic level dosage.
"This study shows that the levels of antibiotics we probably play in the ability of patients to regain basic diversity," he said. "If we pay more attention to drug levels when using these types of antibiotics to ensure that dose is sufficient, we could improve patient clinical outcomes over time."
Source: Children's National Health System