NUTRITIONAL IMPACT OF ANTIPSEUDOMONAS INTRAVENOUS ANTIBIOTIC COURSES IN CYSTIC-FIBROSIS

Objective-To evaluate the short term effects on nutritional status of home intravenous anti-pseudomonas antibiotic courses in cystic fibrosi s (CF) patients chronically colonised with Pseudomonas aeruginosa. Des ign-A prospective study involving 38 CF patients, mean age 10.9 (SD 4. 3) years (range 4.3 to 22.2 years), presenting with pulmonary exacerba tions of P aeruginosa infection. The patients received a 14 day antibi otic course of intravenous ceftazidime (200 mg/kg/day) and either amik acin (35 mg/kg/day) or tobramycin (15 mg/kg/day). Nutritional evaluati on on days 1 and 14 involved measurements of weight, weight/height rat io (per cent of predicted value), energy intake (per cent of recommend ed daily allowances), serum prealbumin, and body composition assessed by two methods: bioelectrical analysis (BIA) and skinfold anthropometr y. The nonparametric Wilcoxon t test was used for statistical analysis , with a Bland-Altman plot to assess the degree of agreement between t he two methods of evaluating body composition. Results-Weight increase d by 1.0 (0.8) kg (p < 0.001); weight/height increased from 94.4(12.2) % to 98(12.7)% (p < 0.001), energy intake from 107(32)% to 119(41)% (p < 0.02), and prealbumin from 183 (63) to 276 (89) mg/1 (p < 0.001). F at mass increased by 0.8 (1.0) kg (p < 0.001), without any significant change in fat-free mass. The Limits of agreement between BIA and anth ropometry were -0.7 kg and +1.1 kg. Conclusions-Antibiotic courses all ow an improvement in nutritional status in CF patients, with a gain in fat mass.