Aerosol therapy in cystic fibrosis: A survey of 54 CF centers

Aerosol therapy has became increasingly important in the treatment of lung disease of patients with cystic fibrosis (CF). Still, many questions concer ning this therapy remain unanswered. It is unclear at what age aerosol ther apy should be started; which aerosolized drugs are essential in the treatme nt of CF lung disease; which delivery system(s) should be used; and how aer osol therapy should be timed in relation to physiotherapy. We hypothesized that large differences in aerosol treatment practices between CF centers wo uld be present. To investigate this, we performed an observational survey t o evaluate different aspects of aerosol therapy. A questionnaire was sent t o 102 CF centers in 28 different countries. A completed questionnaire was returned by 54 out of 94 centers (57%). In th ese 54 centers, 7,324 CF patients were treated. Substantial differences wer e found in aerosol therapy between centers. Patients below age 1 year were not treated with any form of aerosol therapy in 10% of the centers, while 3 7.5% of the centers treated all of these patients. The timing of nebulizati on and physiotherapy varied substantially for many important and expensive drugs. We conclude that many aspects of aerosol therapy in cystic fibrosis need to be executed in a more rational and evidence-based manner than is currently the case. (C) 2000 Wiley-Liss, Inc.