Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1997 May;76(5):437–440. doi: 10.1136/adc.76.5.437

Nutritional impact of antipseudomonas intravenous antibiotic courses in cystic fibrosis

P Vic 1, S Ategbo 1, F Gottrand 1, V Launay 1, G Loeuille 1, J Elian 1, D Druon 1, J Farriaux 1, D Turck 1
PMCID: PMC1717178  PMID: 9196361

Abstract

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.



Full Text

The Full Text of this article is available as a PDF (86.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Azcue M., Fried M., Pencharz P. B. Use of bioelectrical impedance analysis to measure total body water in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr. 1993 May;16(4):440–445. doi: 10.1097/00005176-199305000-00017. [DOI] [PubMed] [Google Scholar]
  2. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  3. Borowitz D., Conboy K. Are bioelectric impedance measurements valid in patients with cystic fibrosis? J Pediatr Gastroenterol Nutr. 1994 May;18(4):453–456. doi: 10.1097/00005176-199405000-00008. [DOI] [PubMed] [Google Scholar]
  4. Bowler I. M., Green J. H., Wolfe S. P., Littlewood J. M. Resting energy expenditure and substrate oxidation rates in cystic fibrosis. Arch Dis Child. 1993 Jun;68(6):754–759. doi: 10.1136/adc.68.6.754. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brook C. G. Determination of body composition of children from skinfold measurements. Arch Dis Child. 1971 Apr;46(246):182–184. doi: 10.1136/adc.46.246.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dodge J. A. Nutritional requirements in cystic fibrosis: a review. J Pediatr Gastroenterol Nutr. 1988;7 (Suppl 1):S8–11. doi: 10.1097/00005176-198811001-00003. [DOI] [PubMed] [Google Scholar]
  7. Durnin J. V., Rahaman M. M. The assessment of the amount of fat in the human body from measurements of skinfold thickness. Br J Nutr. 1967 Aug;21(3):681–689. doi: 10.1079/bjn19670070. [DOI] [PubMed] [Google Scholar]
  8. Gaskin K. J. The impact of nutrition in cystic fibrosis: a review. J Pediatr Gastroenterol Nutr. 1988;7 (Suppl 1):S12–S17. doi: 10.1097/00005176-198811001-00004. [DOI] [PubMed] [Google Scholar]
  9. Girardet J. P., Tounian P., Sardet A., Veinberg F., Grimfeld A., Tournier G., Fontaine J. L. Resting energy expenditure in infants with cystic fibrosis. J Pediatr Gastroenterol Nutr. 1994 Feb;18(2):214–219. doi: 10.1097/00005176-199402000-00015. [DOI] [PubMed] [Google Scholar]
  10. Grunow J. E., Azcue M. P., Berall G., Pencharz P. B. Energy expenditure in cystic fibrosis during activities of daily living. J Pediatr. 1993 Feb;122(2):243–246. doi: 10.1016/s0022-3476(06)80122-8. [DOI] [PubMed] [Google Scholar]
  11. Kraemer R., Rüdeberg A., Hadorn B., Rossi E. Relative underweight in cystic fibrosis and its prognostic value. Acta Paediatr Scand. 1978 Jan;67(1):33–37. doi: 10.1111/j.1651-2227.1978.tb16273.x. [DOI] [PubMed] [Google Scholar]
  12. Naon H., Hack S., Shelton M. T., Gotthoffer R. C., Gozal D. Resting energy expenditure. Evolution during antibiotic treatment for pulmonary exacerbation in cystic fibrosis. Chest. 1993 Jun;103(6):1819–1825. doi: 10.1378/chest.103.6.1819. [DOI] [PubMed] [Google Scholar]
  13. Ramsey B. W., Farrell P. M., Pencharz P. Nutritional assessment and management in cystic fibrosis: a consensus report. The Consensus Committee. Am J Clin Nutr. 1992 Jan;55(1):108–116. doi: 10.1093/ajcn/55.1.108. [DOI] [PubMed] [Google Scholar]
  14. Schaefer F., Georgi M., Zieger A., Schärer K. Usefulness of bioelectric impedance and skinfold measurements in predicting fat-free mass derived from total body potassium in children. Pediatr Res. 1994 May;35(5):617–624. [PubMed] [Google Scholar]
  15. Shepherd R. W., Holt T. L., Cleghorn G., Ward L. C., Isles A., Francis P. Short-term nutritional supplementation during management of pulmonary exacerbations in cystic fibrosis: a controlled study, including effects of protein turnover. Am J Clin Nutr. 1988 Aug;48(2):235–239. doi: 10.1093/ajcn/48.2.235. [DOI] [PubMed] [Google Scholar]
  16. Smith A. L., Ramsey B., Redding G., Haas J. Endobronchial infection in cystic fibrosis. Acta Paediatr Scand Suppl. 1989;363:31–36. doi: 10.1111/apa.1989.78.s363.31. [DOI] [PubMed] [Google Scholar]
  17. Spicher V., Roulet M., Schaffner C., Schutz Y. Bio-electrical impedance analysis for estimation of fat-free mass and muscle mass in cystic fibrosis patients. Eur J Pediatr. 1993 Mar;152(3):222–225. doi: 10.1007/BF01956149. [DOI] [PubMed] [Google Scholar]
  18. Steinkamp G., Drommer A., von der Hardt H. Resting energy expenditure before and after treatment for Pseudomonas aeruginosa infection in patients with cystic fibrosis. Am J Clin Nutr. 1993 May;57(5):685–689. doi: 10.1093/ajcn/57.5.685. [DOI] [PubMed] [Google Scholar]
  19. Suter S., Schaad U. B., Roux-Lombard P., Girardin E., Grau G., Dayer J. M. Relation between tumor necrosis factor-alpha and granulocyte elastase-alpha 1-proteinase inhibitor complexes in the plasma of patients with cystic fibrosis. Am Rev Respir Dis. 1989 Dec;140(6):1640–1644. doi: 10.1164/ajrccm/140.6.1640. [DOI] [PubMed] [Google Scholar]
  20. Szaff M., Høiby N., Flensborg E. W. Frequent antibiotic therapy improves survival of cystic fibrosis patients with chronic Pseudomonas aeruginosa infection. Acta Paediatr Scand. 1983 Sep;72(5):651–657. doi: 10.1111/j.1651-2227.1983.tb09789.x. [DOI] [PubMed] [Google Scholar]
  21. Vaisman N., Pencharz P. B., Corey M., Canny G. J., Hahn E. Energy expenditure of patients with cystic fibrosis. J Pediatr. 1987 Oct;111(4):496–500. doi: 10.1016/s0022-3476(87)80107-5. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES