Landmark clinical trial shows effectiveness of oral antibiotics in treating cystic fibrosis condition

September 29, 2020

A major national study led by experts from Bristol and Nottingham has found that oral antibiotics are just as effective as intravenous antibiotics in killing a common germ that causes dangerous complications in cystic fibrosis (CF) patients.

The study looked at the effectiveness of the two types of treatment in tackling Pseudomonas aeruginosa, which causes a chronic destructive lung infection in CF patients and which cannot be eradicated unless it is caught in the early stages.

Dr Simon Langton Hewer, a consultant respiratory paediatrician at University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) and chief investigator of the study with colleagues at the University of Nottingham, said: "I'm very excited to be able to share the results of this very important study which has implications for adults and children with CF who have a new infection of Pseudomonas aeruginosa.

"Our study found that traditional oral antibiotics are just as effective as intravenous antibiotics, which means that CF patients who have a new Pseudomonas aeruginosa can be treated at home and saved the inconvenience of having to be admitted to hospital for treatment.

"The results of the study provide evidence to guide practice in CF centres and will help to reduce unnecessary hospital admissions."

Pseudomonas aeruginosa is a bacterium that lives in the environment, lurking in places such as sink drains. Most CF patients have chronic lung infection with the germ by their late teens. Oral and nebulised (inhaled) antibiotics have mainly been used to eradicate Pseudomonas, but are only effective if the infection is caught in time.

Intravenous antibiotics are used commonly to eradicate the infection, however until now there was no clear scientific evidence that intravenous treatment is any better than oral. The TORPEDO trial has shown that routine use of intravenous antibiotics, to eradicate Pseudomonas, is not justified. However, there will still be circumstances (such as a worsening cough or drop in lung function) where intravenous treatment will be needed. Intravenous treatment means that patients with CF need to spend up to two weeks in hospital.

The 10 year trial was sponsored by UHBW and funded with £1.5 million from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. In total 286 patients took part in the study at 70 CF centres and clinics around the UK and two in Italy. The findings of the study will be published in The Lancet Respiratory Medicine.

Professor Alan Smyth, from the University of Nottingham's School of Medicine and a co-chief investigator in the TORPEDO clinical trial, said: "For many years we felt we should admit children with cystic fibrosis for intravenous antibiotics when they first had a Pseudomonas infection.

"This can be upsetting for the child and their family and can disrupt school and family life. Thanks to the TORPEDO trial, we now know that oral and inhaled treatment is at least as effective as intravenous, in most cases. In future, we can give this treatment at home and avoid the inconvenience and expense of a hospital admission."

The results of the study have been welcomed by the families of patients and the Cystic Fibrosis Trust.

Adele Farrow's daughter Niamh, who is aged 13 and who has Cystic Fibrosis, took part in the trial.

Adele, from Pilning, South Gloucestershire, said: "This is an amazing result that would really change life for Niamh and us as a family if Niamh developed Pseudomonas.

"Not having to go into hospital and have intravenous medication is a big thing and it's really positive that the results would mean she could stay at home for antibiotics if she developed this infection."

Dr Keith Brownlee, director of policy, programmes and support at the Cystic Fibrosis Trust, said: "This is great news for people with cystic fibrosis. These findings may reduce the time spent in hospital, where they and their families are forced to take time off work and school. This will ultimately improve quality of life for many people with CF."
-end-


University of Nottingham

Related Antibiotics Articles from Brightsurf:

Insights in the search for new antibiotics
A collaborative research team from the University of Oklahoma, the Memorial Sloan Kettering Cancer Center and Merck & Co. published an opinion article in the journal, Nature Chemical Biology, that addresses the gap in the discovery of new antibiotics.

New tricks for old antibiotics
The study published in the journal Immunity reveals that tetracyclines (broad spectre antibiotics), by partially inhibiting cell mitochondria activity, induce a compensatory response on the organism that decreases tissue damage caused during infection.

Benefits, risks seen with antibiotics-first for appendicitis
Antibiotics are a good choice for some patients with appendicitis but not all, according to study results published today in the New England Journal of Medicine.

How antibiotics interact
Understanding bottleneck effects in the translation of bacterial proteins can lead to a more effective combination of antibiotics / study in 'Nature Communications'

Are antivitamins the new antibiotics?
Antibiotics are among the most important discoveries of modern medicine and have saved millions of lives since the discovery of penicillin almost 100 years ago.

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.

Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.

Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.

Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.

Read More: Antibiotics News and Antibiotics Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.