The use of CFTR modulators has transformed the treatment of cystic fibrosis in recent years, especially following approval of the triple combination. Patients who are eligible for triple CFTR modulator therapy perceive that their overall health is improving and stabilizing significantly with having less mucus in their airways.
In view of these advances, many people wonder whether their treatment – which for most of them has traditionally been inhalation therapy, physiotherapy and systemic drug therapy – can be adapted or even has to be adapted.
A renowned team of cystic fibrosis experts collaborating with J. Stuart Elborn (Faculty of Medicine Health and Life Sciences, Queen’s University, Belfast, UK) have now tackled this question. In their paper recently published in the European Respiratory Review, they address inhaled antibiotics in the era of highly effective CFTR modulators .
Their clear conclusion: Inhaled antibiotics are still recommended for patients receiving CFTR modulators who present with chronic infections. This is because there are no long-term data to prove that it is safe to stop taking antibiotics.
Recurrent or chronic bacterial infection with Pseudomonas aeruginosa harbours a host of risks. Bacterial airway infections are strongly associated with exacerbations, limited quality of life and increased mortality [2,3].
The use of inhaled antibiotics for cystic fibrosis patients is an evidence-based treatment with a long-standing track record in the management of chronic infection with Pseudomonas aeruginosa [4,5].
Early intervention with inhaled antibiotics, as monotherapy or combined with oral antibiotics, is also an effective strategy to delay chronic colonisation with Pseudomonas aeruginosa [4,5].
1 Elborn JS, Blasi F, Burgel P-R et al. Eur Respir Rev 2023; 32: 220154.
2 VanDevanter DR et al. J Cyst Fibros 2015; 14: 763–769.
3 Turcios NL Respir Care 2020; 65: 233–251.
4 Taccetti G et al. Antibiotics 2021; 10: 338.
5 Castellani C et al. J Cyst Fibros 2018; 17: 153–178.