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CF pulmonary exacerbation — SCE Respiratory MCQ

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HardCystic fibrosisCF pulmonary exacerbationSCE Respiratory

A 22-year-old woman with cystic fibrosis is admitted with increased cough, weight loss and a fall in FEV1 from 72% to 55% predicted. Sputum has chronically grown Pseudomonas aeruginosa sensitive to ceftazidime and tobramycin. She is afebrile but has increased sputum volume and reduced exercise tolerance. Renal function and hearing are normal. What is the most appropriate management?

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Correct answer: E — Intravenous antipseudomonal combination therapy guided by cultures

CF pulmonary exacerbation with a significant FEV1 fall and chronic Pseudomonas usually requires culture-guided antipseudomonal therapy. Fever is not required for an exacerbation diagnosis. Aminoglycoside toxicity monitoring is important when tobramycin is used.

Reference: CF Trust Standards of Care; NICE cystic fibrosis guidance