Kaiser Permanente Northwest, Department of Pulmonary and Critical Care Medicine; Kaiser Permanente Center for Health Research, Portland, OR, USA.
Kaiser Permanente Northwest, Department of Pediatrics; Kaiser Permanente Cystic Fibrosis Clinic, Portland, OR, USA.
Perm J. 2022 Apr 5;26(1):73-79. doi: 10.7812/TPP/21.089.
Elexacaftor/tezacaftor/ivacaftor (ETI) is a highly effective cystic fibrosis transmembrane conductance regulator modulator. It has been shown to improve lung function and decrease pulmonary exacerbations in short-term clinical trials. The effect of ETI on hospitalization and intravenous (IV) antibiotic rates is not known. We performed a single-institution, retrospective review comparing these rates before and after the initiation of ETI.
Among patients taking the cystic fibrosis modulator ETI, we compared the cumulative number of days per month hospitalized and cumulative number of days per month on IV antibiotics before and after the initiation of ETI. Electronic medical records from 37 patients were reviewed from 2016 through 2020 to identify demographic data, hospitalizations, and antibiotic use. Results were then stratified by severity of lung disease.
Following the initiation of ETI, there was a decline in days per month hospitalized and on IV antibiotics. The cumulative average number of days per month patients were hospitalized decreased 86% from 27 to 4 after starting ETI. The cumulative average number of days per month on IV antibiotics decreased by 80% (32.5 to 6.4). Most of these reductions occurred among patients with severe lung disease.
At our institution, we saw a decline in cystic fibrosis-related hospitalizations and in the use of outpatient IV antibiotics following the initiation of ETI. These reductions were most pronounced among patients with severe lung disease.
The initiation of ETI was associated with a decline in days hospitalized and days on IV antibiotics.
依伐卡托/泰它卡托/维加特（ETI）是一种高效的囊性纤维化跨膜电导调节剂调节剂。它已被证明能在短期临床试验中改善肺功能并减少肺部恶化。ETI 对住院和静脉（IV）抗生素率的影响尚不清楚。我们进行了一项单机构、回顾性研究，比较了 ETI 开始前后这些比率。
在接受囊性纤维化调节剂 ETI 的患者中，我们比较了 ETI 开始前后每月住院和每月静脉使用抗生素的累计天数。从 2016 年到 2020 年，从 37 名患者的电子病历中回顾了人口统计学数据、住院和抗生素使用情况。结果按肺部疾病严重程度进行分层。
在开始 ETI 后，住院和静脉使用抗生素的天数减少。患者每月住院的累计平均天数从开始 ETI 前的 27 天减少了 86%，至 4 天。每月静脉使用抗生素的累计平均天数减少了 80%（从 32.5 天减少至 6.4 天）。这些减少主要发生在肺部疾病严重的患者中。
在我们的机构中，在开始 ETI 后，囊性纤维化相关住院和门诊静脉使用抗生素的数量减少。在肺部疾病严重的患者中，这种减少最为明显。
ETI 的启动与住院天数和静脉使用抗生素天数的减少有关。
