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Evidence for using nebulised antibiotics in cystic fibrosis
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Introduction |
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Standards of care for patients with cystic fibrosis (CF) have been defined largely on the basis of "best practice", an accolade awarded to treatment regimens showing low chronic pulmonary infection rates, greatest patient longevity, and least patient morbidity. While acknowledging the wisdom accrued through clinical experience, paediatricians caring for children with CF are fighting for limited resources and must convince purchasers, who stroll the fashionable catwalk of evidence based medicine, of the scientific basis of our demands. They ask, "Where's the beef?" For the use of nebulised antibiotics in CF care we can reply only that we have a lot of "topside" but few "prime cuts".
Clinical trials, the results of which affect all of our prescription
practices, have been generally parochial in conception, bedevilled by
small patient numbers, and underpowered, partly reflecting patient
recruitment problems for research into an illness that affects only a
small minority of the population
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