Table 1.

Summary of the Most Widely Recognized Definitions of a PEx

Definition	Criteria to Define a PEx	Detail
EuroCareCF, 20116	When additional antibiotics are needed due to a recent change in at least 2 items from a predefined list	Change in sputum volume or color; increased cough; increased fatigue, malaise, or lethargy; anorexia or weight loss; increased shortness of breath; decrease in pulmonary function by ≥ 10% compared with previous or radiographic changes consistent with a PEx
Rabin et al,7 2004	Three or more signs/symptoms	In patients > 6 years old: relative decline in FEV1; increased cough frequency; new crackles; hemoptysis
Rosenfeld et al,8 2001	Combined points system to diagnose a PEx and quantify its severity. Two models proposed, one using FEV1	Model 1: decreased exercise tolerance; increased cough; increased sputum/cough clearance; increased sputum/cough congestion; school or work absenteeism; change in lung examination; decreased appetite Model 2: as per model 1; change in FEV1
Ramsey et al,9 1999	At least 2 signs/symptoms from a predefined list and 1 from a second list	List 1: Fever > 38°C; ≥ 50% increase in cough; 50% increase in sputum volume; loss of appetite; weight loss of ≥ 1 kg; absence from school or work for at least 3 of the preceding 7 days due to illness; symptoms of an upper respiratory tract infection List 2: decrease in FEV1 of at least 10%; increase in respiratory rate of at least 10 breaths/min; peripheral neutrophil count of > 15
Fuchs et al,5 1994	At least 4 signs/symptoms from a predefined list	Change in sputum; new or increased hemoptysis; increased cough; increased shortness of breath; malaise/fatigue/lethargy; temperature > 38°C; anorexia or weight loss; sinus pain or tenderness; change in sinus discharge; change in physical examination of the chest; decrease in pulmonary function by ≥ 10% compared with previous; radiographic changes consistent with a pulmonary exacerbation

PEx = pulmonary exacerbation.