Optimizing treatment policies and improving care: impact on outcome in patients with cystic fibrosis

There is no cure for cystic fibrosis but recent advances in care have increased the average life expectancy to over 30 years. However, patients may find themselves prescribed over seven to eight different medications a day, some of which are laborious and time consuming to administer. The physician should balance potential benefits from treatments against quality-of-life requirements. In this review, the authors examine the place in the overall treatment regimen of recently available, and often expensive, drugs. The review concentrates on eradication regimens for early or recurrent Pseudomonas aeruginosainfection; inhaled tobramycin therapy; regular versus on-demand intravenous antibiotics; treatment of respiratory methicillin-resistant Staphylococcus aureusinfection; the role of macrolide antibiotics and the role of inhaled dornase alfa in early treatment.