This study examined serious lung infections, known as pulmonary exacerbations, in people with cystic fibrosis (CF) who needed treatment with intravenous (IV) antibiotics. These severe flare-ups are important because they can cause lasting drops in lung function and have a major impact on health. With highly effective CFTR modulators now being widely used, the CF community and CF doctors want to know whether long-standing treatment approaches for serious flare-ups still make sense.

The BEAT CF cohort followed nearly 1,000 people with CF from 11 specialist centres in Australia. Between 2020 and 2024, the study recorded 593 severe flare-ups in 323 individuals, and about two-thirds of these occurred in people already taking CFTR modulator therapy. The most commonly used IV antibiotics were tobramycin and piperacillin-tazobactam (Tazocin).

Lung function was measured before treatment, and again during treatment and recovery. Many patients did not fully recover their lung function within the first week following start of treatment. Even after two months, 44% still had not returned to their pre-flare-up lung function, although only 8% had a major drop (more than 10%). Notably, this pattern was the same regardless of whether or not someone was on modulator therapy, how good their initial lung function was, or whether they had previously tested positive for Pseudomonas aeruginosa.

Overall, the study shows that lung function reduction during these serious flare-ups is similar among people on modulator therapy and in those not taking modulators. This suggests that modulators do not eliminate the risk of incomplete recovery after a flare-up. This highlights the need for better evidence to guide treatment decisions for severe exacerbations, so that doctors can strike the right balance between the burden of intensive treatment and the risk of permanent lung function loss.

For the full article please visit: Characteristics, treatment, and lung function outcomes of pulmonary exacerbations in cystic fibrosis: insights from the BEAT-CF cohort – PubMed