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Arch Dis Child 1997;76:437-440 ( May )

Nutritional impact of antipseudomonas intravenous antibiotic courses in cystic fibrosis

P Vic,a S Ategbo,a F Gottrand,a V Launay,a G A Loeuille,b J C Elian,c D Druon,c J P Farriaux,a D Turcka

a Department of Paediatrics, Lille University Hospital, Lille, France, b Department of Paediatrics, Dunkirk City Hospital, Dunkirk, France, c Department of Paediatrics, Camiers City Hospital, Camiers, France

Correspondence to: Professor D Turck, Service de Pédiatrie, Hôpital Huriez, 59037 Lille Cédex, France.

Accepted 21 November 1996

OBJECTIVE---To evaluate the short term effects on nutritional status of home intravenous anti-pseudomonas antibiotic courses in cystic fibrosis (CF) patients chronically colonised with Pseudomonas aeruginosa.
DESIGN---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 exacerbations of P aeruginosa infection. The patients received a 14 day antibiotic course of intravenous ceftazidime (200 mg/kg/day) and either amikacin (35 mg/kg/day) or tobramycin (15 mg/kg/day). Nutritional evaluation on days 1 and 14 involved measurements of weight, weight/height ratio (per cent of predicted value), energy intake (per cent of recommended daily allowances), serum prealbumin, and body composition assessed by two methods: bioelectrical analysis (BIA) and skinfold anthropometry. The non-parametric Wilcoxon t test was used for statistical analysis, with a Bland-Altman plot to assess the degree of agreement between the two methods of evaluating body composition.
RESULTS---Weight increased 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/l (p < 0.001). Fat 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 anthropometry were -0.7 kg and +1.1 kg.
CONCLUSIONS---Antibiotic courses allow an improvement in nutritional status in CF patients, with a gain in fat mass.

Keywords: cystic fibrosis; antibiotics; anthropometry; bioelectrical analysis


© 1997 by Archives of Disease in Childhood



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