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Duration of intravenous antibiotic treatment for respiratory exacerbations in children with cystic fibrosis
  1. S M N Brown,
  2. I M Balfour-Lynn
  1. Department of Respiratory Paediatrics, Royal Brompton Hospital, Royal Brompton & Harefield NHS Trust, London, UK
  1. Correspondence to Dr Sarah M N Brown, Department of Respiratory Paediatrics, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; s.brown3{at}rbht.nhs.uk

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Over the past decades, the continued improvement in survival of patients with cystic fibrosis (CF) has partly been attributed to improved nutritional status and aggressive treatment of respiratory exacerbations.1 Standard intravenous antibiotic treatment for an exacerbation lasts 14 days, and most centres follow this guideline.2 Some patients receive courses >14 days, usually for continuing symptoms or inadequate improvement in lung function. However, there is limited evidence to guide the optimum duration, and a Cochrane systematic review in 2008 found that there were no clear guidelines available and suggested that a multicentre, randomised, controlled trial was necessary.3 Courses that are too long are likely to lead to increased antibiotic resistance and possibly more allergic reactions.4 There may also be an increase in significant adverse effects, particularly from aminoglycosides. Additionally, there are increased financial …

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