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Technological and behavioral strategies to reduce treatment burden and improve adherence to inhaled antibiotics in cystic fibrosis

Respiratory Medicine, pages S24 - S31


Aerosolized antibiotics are a common treatment option for patients with cystic fibrosis and chronic airway infection, as high doses can be delivered topically to the site of the infection while systemic exposure is minimized. Patients also use other aerosolized therapies (e.g. mucus-active agents, airway-wetting agents, and bronchodilators), adding significantly increase timed and complexity to their daily regimen, and often leading to lower adherence rates. A number of novel technological strategies are available that may reduce dose frequency and increase the speed of drug delivery. Psychologically based therapies may also be used to help modify behavior and thus improve adherence to treatment. Clinicians need to explore both technological and psychological strategies that will assist in the successful maintenance of treatment requirements.

Keywords: Cystic fibrosis, Behavioral strategies, Technological strategies, Pseudomonas aeruginosa, Inhaled antibiotics, Pulmonary exacerbations, Treatment adherence.


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a Nemours Children's Clinic, Orlando, Florida, USA

b Royal Brompton Hospital, London, England, UK

* Corresponding author. David E. Geller, MD. Director, Aerosol Research Lab & CF Center, Nemours Children's Clinic, 496 S Delaney Avenue, #406A, Orlando, FL 3280, USA. Tel.: +1 407 650 7715; fax: +1 407 650 7124