Do cystic fibrosis centres with the lowest FEV1 still use the least amount of intravenous antibiotics? A registry-based comparison of intravenous antibiotic use among adult CF centres in the UK

Abstract

BackgroundThe Epidemiologic Study of Cystic Fibrosis using 1995–1996 and 2003–2005 data found that CF centres with lowest FEV1 tended to use fewer intravenous antibiotics. We repeated the analyses using 2013–2014 UK CF registry data to determine if this was still the case. MethodsAnalysing data for 2013 and 2014 separately, 28 adult CF centres were ranked according to median % age-adjusted FEV1. The top 7 centres were placed in the ‘upper quarter’ (best FEV1), the bottom 7 centres in ‘lower quarter’ (lowest FEV1), and the rest in ‘middle half’. IV use was stratified according to %FEV1, then compared between the three groups. ResultsCentres in the ‘upper quarter’ and ‘middle half’ used significantly more IV antibiotics compared to centres in the ‘lower quarter’ (van Elteren test P-value<0.001). Regression analyses showed that people with CF attending centres in the ‘upper quarter’ or ‘middle half’ are 30–50% more likely to receive at least one IV course per year compared to people attending centres in the ‘lower quarter’. ConclusionsCF centres with lowest FEV1 are still distinguished by lower use of intravenous antibiotics.