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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 …
Competing interest None.
Provenance and peer review Not commissioned; internally peer reviewed.
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