CFDB - Cystic Fibrosis DataBase

primary studies published RCT

Home versus hospital therapy including intravenous antibiotics in cystic fibrosis.

Study design (if review, criteria of inclusion for studies)

randomised study

Participants

adult CF patients from the Brisbane region. To date, 12 patients aged 18-29 years have had 13 admissions. 5 patients were randomised to home therapy and returned home after 2-4 days in hospital.

Interventions

home versus hospital IV therapy. Initial treatment was with ceftazidime 2g bd and tobramycin 4-6mg/kg in a single daily dose

Outcome measures

Home visits were conducted by the researcher. All patients were monitored by lung function, 12-minute walk, renal function, aminoglycoside levels and weight. A quality of life questionnaire was administered on admission and after cessation of treatment. In addition, patients were asked which treatment option they preferred.

Main results

All patients improved with treatment, 2 required a change in antibiotics after failure to respond initially. No patient on home treatment required hospital readmission. No adverse events or signs of antibiotic toxicity were noted. 9 out of 12 patients preferred home therapy. Lung function (expressed as percent change of mean predicted FEV1), improved by (mean_SD). 1.76_4.27% in the home group and 4.74_8.85% in the hospital group. 12-minute walk distances improved by 4.2_8.6% at home and 19.0_22.1% in hospital. Weight in the home group increased by 0.69_0.98kg compared to 0.54_1.16kg in hospital. Quality of life after treatment at home improved by 21.1_22.2 points, and 28.38_12.29 after hospital treatment. There were no significant differences demonstrated between home and hospital therapy (unpaired t-test), however small sample size may contribute to type II error in these results. Patient recruitment continues

Keywords: Anti-Bacterial Agents; Home; Hospitalization; Hospital care; Intravenous; non pharmacological intervention - psyco-soc-edu-org; Bacterial Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Infection; Ceftazidime; Tobramycin; Cephalosporins; Organization; Aminoglycosides;