RT Journal Article
SR Electronic
T1 Role of inhaled antibiotics in the era of highly effective CFTR modulators
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 220154
DO 10.1183/16000617.0154-2022
VO 32
IS 167
A1 J. Stuart Elborn
A1 Francesco Blasi
A1 Pierre-Régis Burgel
A1 Daniel Peckham
YR 2023
UL http://err.ersjournals.com/content/32/167/220154.abstract
AB Recurrent and chronic bacterial infections are common in people with cystic fibrosis (CF) and contribute to lung function decline. Antibiotics are the mainstay in the treatment of exacerbations and chronic bacterial infection in CF. Inhaled antibiotics are effective in treating chronic respiratory bacterial infections and eradicating Pseudomonas aeruginosa from the respiratory tract, with limited systemic adverse effects. In the past decade, highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulators have become a new therapy that partially corrects/opens chloride transport in patients with selected CFTR mutations, restoring mucus hydration and improving mucociliary clearance. The recent triple CFTR modulator combination is approved for ∼80–90% of the CF population and significantly reduces pulmonary exacerbations and improves respiratory symptoms and lung function. CFTR modulators have shifted the focus from symptomatic treatment to personalised/precision medicine by targeting genotype-specific CFTR defects. While these are highly effective, they do not fully normalise lung physiology, stop inflammation or resolve chronic lung damage, such as bronchiectasis. The impact of these new drugs on lung health is likely to change the future management of chronic pulmonary infections in people with CF. This article reviews the role of inhaled antibiotics in the era of CFTR modulators.Studies are needed to determine whether discontinuing maintenance therapy is safe in people with cystic fibrosis receiving CFTR modulators. Until then, people with CF are recommended to continue their prescribed medications, including antibiotic therapy. https://bit.ly/3ML3nYw