Impact of Elexacaftor/Tezacaftor/Ivacaftor on Systemic Antibiotic Utilization in Pediatric Patients With Cystic Fibrosis.

IF 2.4 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2026-08-01 DOI:10.1002/ppul.71749

Julianne Fava, Emily Stephan, Jessica Tansmore, Shahid Sheikh, Mariah Eisner, Kimberly J Novak

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引用次数: 0

Abstract

Introduction: Cystic fibrosis (CF) is an autosomal recessive disease resulting from mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Recurrent respiratory infections are a common problem, and patients receive frequent antibiotics. Treatment of CF involves both symptomatic and underlying disease-targeting therapies. Elexacaftor/tezacaftor/ivacaftor (ETI), a disease-targeting therapy, combines two correctors and a potentiator to increase functioning of the CFTR channel. With better functioning channels, symptomatic improvement is expected in the form of decreased respiratory infections.

Objective: To evaluate the change in antibiotic use following the initiation of ETI therapy in pediatric patients.

Methods: This is a single-center, retrospective chart review conducted at Nationwide Children's Hospital (NCH) in Columbus, Ohio. Patients served as self-controls, compared before and after initiating ETI. The primary outcome was change in antibiotic days per patient-year. Secondary outcomes included change in use of specific antibiotics, enteral versus intravenous (IV) therapy, and different classes of antibiotics. The study was approved by the NCH institutional review board (IRB).

Results: The study included 139 patients aged 6-18 years. The median antibiotic days per patient-year was 17 days pre-ETI and 6 days post-ETI (p < 0.001). There was a significant decrease in antibiotic days per patient-year for subgroups of IV antibiotics, enteral antibiotics, IV vancomycin, linezolid and tedizolid, anti-methicillin-resistant Staphylococcus aureus (MRSA) tetracyclines, other anti-MRSA medications (clindamycin and trimethoprim/sulfamethoxazole), aminoglycosides, anti-Pseudomonas aeruginosa (Psae) beta-lactams, and fluoroquinolones. There was no significant difference for carbapenems or non-anti-Psae beta-lactams.

Conclusion: ETI therapy was associated with decreased antibiotic days for many therapeutic classes of both enteral and IV antibiotics.

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elexaftor /Tezacaftor/Ivacaftor对儿童囊性纤维化患者全身抗生素使用的影响

简介：囊性纤维化（CF）是一种常染色体隐性遗传病，由囊性纤维化跨膜传导调节基因（CFTR）突变引起。反复呼吸道感染是一个常见的问题，患者经常接受抗生素治疗。CF的治疗包括对症和潜在疾病靶向治疗。elexaftor /tezacaftor/ivacaftor （ETI）是一种疾病靶向治疗，结合了两种校正剂和一种增强剂来增加CFTR通道的功能。随着通道功能的改善，呼吸道感染的减少有望改善症状。目的：评价儿科患者开始ETI治疗后抗生素使用的变化。方法：这是一项在俄亥俄州哥伦布市全国儿童医院（NCH）进行的单中心回顾性图表综述。患者进行自我控制，比较ETI启动前后的差异。主要结果是每位患者每年使用抗生素天数的变化。次要结局包括使用特定抗生素的变化，肠内与静脉（IV）治疗，以及不同种类的抗生素。该研究已获得NCH机构审查委员会（IRB）的批准。结果：纳入139例6-18岁患者。每位患者年平均使用抗生素天数分别为ETI前17天和ETI后6天(p结论：ETI治疗与许多治疗类别的肠内和静脉抗生素使用抗生素天数减少有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.