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SHR Neuro Cancer Cardio Lipid Metab Microb
Muhlebach, MS; Naehrlich, L; Carr, SB; Orenti, A; Gambazza, S, , ECFS, Patient, Registry, Steering, Group.
CHANGES IN USE OF INHALED CHRONIC ANTIBIOTICS IN THE EUROPEAN CF POPULATION, A ECFS PATIENT REGISTRY STUDY.
Respir Med. 2025; 108465
Doi: 10.1016/j.rmed.2025.108465
PubMed
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- Abstract:
- BACKGROUND: Improved outcomes of people with CF (pwCF) in the last decade require reconsidering prescriptions of chronic inhaled antibiotics (iABs). We compared iABs between countries with similar CF-care structures and tested for temporal trends in Pa infection and in factors associated with iABs. METHODS: Data from ECFSPR 2011-2019 was extracted for UK, France, Italy, Netherlands, Belgium, Ireland, Switzerland, and Austria for non-transplanted pwCF >2-years. Multivariable generalized estimating equation modelling was used to identify factors associated with iABs. Predictors of interest included demographics, co-infections, and disease severity. RESULTS: Prevalence (median) of chronic Pa decreased from 36% in 2012 to 28% in 2019 (p=0.023) among the 19,853 included pwCF. Proportion of iABs for chronic Pa across countries increased from (median (range)) 80.8 (61.6-87.4)% in 2012 to 87.8 (77.9-94.7)% in 2019 (p=0.02). Prescriptions for non-chronic Pa remained similar: 21.4 (13.0-48.2)% and 24.0 (15.0-42.6)% (p=0.74). Conversion of chronic to non-chronic Pa between 2012 to 2019 occurred in 25% on iABs and 32% without iABs. Conversion to chronic Pa were 27% on iABs vs. 13% without iABs. Factors associated with iABs regardless of Pa were pancreatic insufficiency, azithromycin and mucolytics. Markers of worse disease and S. maltophilia positive cultures were associated with iABs for pwCF without chronic Pa. Over time, chronic Burkholderia infection was associated with increasing odds of iABs. CONCLUSIONS: The high iAB prescriptions for non-chronic Pa with country-to-country differences indicate ongoing need for education about antibiotics. Rates of Pa conversions highlight benefits of ongoing microbiology surveillance.