WS14.5 Exercise testing as a supplementary measure to assess the benefit of intravenous antibiotic courses

Abstract

Objectives The use of intravenous antibiotics has long been established as the treatment for respiratory exacerbations in patients colonised with Pseudomonas aeruginosa. However improvements in spirometry are not always demonstrated following treatment. Patients often place significant importance on these readings and may doubt the benefit of treatment if an increase in lung function is not seen. A small study comparing the results of exercise test results with spirometry at the start and end of a course of intravenous antibiotics to see if they could be used as a supplementary measure to assess the benefit of treatment. Methods 27 patients (63% male; mean age 35 yrs, range 17–70; mean % FEV1 45.7%, range 17–86%) who were admitted for a two week course of intravenous antibiotics were approached to check their lung function and exercise tolerance at the start of their admission. 18 patients agreed and 9 declined. The tests were then repeated at the end of the hospital admission. The incremental shuttle walk test and the 6 minute walk test were used depending on patient preference. Results 10 patients (55%) show improvement in both their spirometry and exercise tolerance, however 8 patients (45%) demonstrated less than a 2% increase in their lung function; 3 recording a lower value than at the start of treatment. Of these 8 patients, 7 showed improvements in their exercise test results, mean 48.6%, range 7.6–85%. Conclusion Exercise testing as a supplementary measure to assess the benefit of intravenous antibiotic therapy may be of value, particularly in patients who do not show an improvement in spirometry.