Chronic inhaled antibiotic therapy in people with cystic fibrosis with Pseudomonas aeruginosa infection in Germany.

BACKGROUND: Several clinical guidelines recommend chronic inhaled therapy for pwCF (people with cystic fibrosis) and chronic Pseudomonas aeruginosa infection of the lungs. METHODS: To demonstrate what kind of therapy regimens are used in Germany, we retrospectively analysed chronic inhaled antibiotic therapy within the cohort of the German CF Registry in 2020. For comparison we also analysed the use of inhaled antibiotics in pwCF with intermittent Pseudomonas or without Pseudomonas infection. RESULTS: A total of 1960 pwCF had chronic P. aeruginosa infection and were retrospectively evaluated. Almost 90% (n = 1751) received at least one inhaled antibiotic. The most commonly used inhaled antibiotic was colistin solution for inhalation (55.2%), followed by aztreonam solution for inhalation (32.6%) and tobramycin solution for Inhalation (30%). Almost 56% of adults and 44% of children alternated two antibiotics for inhalation. In children, alternating colistin + tobramycin was the most often used regimen. In adults, only 23% used colistin + tobramycin; there was a wide range of treatment regimens among adults using two inhaled antibiotics alternately. 2456 pwCF had no Pseudomonas infection, but almost 24% had a chronic inhaled antibiotic therapy, while 56% of 361 pwCF and intermittent chronic Pseudomonas infection had a chronic inhaled antibiotic therapy. CONCLUSION: In all three groups the most commonly used inhaled antibiotic was colistin solution for inhalation. Almost 56% of adults and 44% of children with chronic Pseudomonas infection alternated two antibiotics for inhalation. It will be interesting to see how the introduction of the highly effective modulator elexacaftor/tezacaftor/ivacaftor will change the use of inhaled antibiotics.

Intergalactic cold dust in the NGC 4631 group.

We have detected extraplanar cold dust at distances out to >10 kiloparsecs, situated in the halo of the interacting galaxy NGC 4631. The dust emission disk is much thinner than the warped HI disk, and new structures emerge. In particular, a giant arc has been found that is linked to anomalies in the kinematical structure of the atomic gas. Most of the extraplanar dust is closely associated with HI spurs that have been found earlier [Weliachew, L., Sancisi, R. & Guelin, M. (1978) Astron. Astrophys. 65, 37-45; Rand, R. J. (1994) Astron. Astrophys. 285, 833-856]. These spurs obviously are traces of the interaction [Combes, F. (1978) Astron. Astrophys. 65, 47-55]. The dust emission within the plane reaches the border of the optical disk. The activity of the disk of NGC 4631 is moderately enhanced by the interaction, but no gas moving in the z-direction could be found [Rand, R. J., Kulkarni, S. R. & Hester, J. J. (1992) Astrophys. J. 396, 97-103; Golla, G., Dettmar, R.-J. & Domgorgen, H. (1996) Astron. Astrophys. 313, 439-447]. Hence, it seems unlikely that strong winds have deposited the high-z dust. Instead, the coincidence with the HI features suggests that we see a track left behind by the interaction. In addition, the HI shows a supershell formed by an impact [Rand, R. J. & Stone, J. M. (1996) Astron. J. 111, 190-196] in the zone where the dust trail crosses the disk. This region is also characterized by disturbances in the distribution of the Halpha light. The masses associated with the dust can be estimated only very roughly on the basis of the existing data; they are of the order of a few 10(9) M middle dot in circle of gas.