Treatment and prevention of pulmonary complications of cystic fibrosis in infancy and early childhood.

Seventy-six patients with cystic fibrosis seen between 1950 and 1964 were studied, all having been first seen before the age of 1 year. In retrospect, the year 1957 seemed to be a watershed in the treatment of this series of patients, and they were therefore divided into 2 groups. Group A, 30 patients seen before 1957; Group B, 46 patients seen after 1957. The clinical, radiological, and bacteriological findings in the 2 groups at entry were similar as to age of incidence, severity of the initial respiratory symptoms, abnormalities on chest radiographs, and bacteriology of the cultures of cough swabs. Treatment of Group B patients was generally more vigorous, with antibiotics used more efficiently to treat pulmonary infection. When the patients were followed up and their pulmonary status was assessed clinically and radiologically, at 1 year and at 5 years of age, Group B patients were found to be significantly less severely affected than Group A patients. It is concluded that vigorous treatment of cystic fibrosis can reduce mortality in infancy, and considerably improve the pulmonary status during childhood.