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Management of respiratory exacerbations 

Management of respiratory exacerbations
Management of respiratory exacerbations

Alex Horsley

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date: 23 September 2018

Early recognition and treatment of CF exacerbations is one of the cornerstones of modern CF care

Diagnosis is essentially clinical, based largely on patient symptoms

Anything other than very mild exacerbations requires intravenous antibiotics, typically for 10–21 days

Choice of antibiotics should be based upon known antimicrobial sensitivities

Monotherapy should be avoided in Pseudomonas infections

In patients colonized with Pseudomonas, treatment usually involves a combination of a β-lactam antibiotic and an aminoglycoside

Treatment can be delivered at home but requires the same assessment as for inpatients, and close monitoring

Treatment is multidisciplinary and also involves attention to physiotherapy, nutrition and glucose homeostasis

Antibiotic hypersensitivities are common, particularly in those with repeated courses of treatment. Antibiotic desensitization can be attempted for each course if necessary.

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