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Management of respiratory exacerbations 

Management of respiratory exacerbations
Chapter:
Management of respiratory exacerbations
Author(s):

Alex Horsley

DOI:
10.1093/med/9780199582709.003.0005
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date: 19 October 2017

• 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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