Potential factors influencing reduced requirements for intravenous antibiotics during the COVID-19 pandemic

ABSTRACT

Objective: The use of intravenous antibiotics (IVAB) is a central part of the management of pulmonary infections in cystic fibrosis (CF). Adult patients with CF in England were advised to “shield” by the government (23.03.2020–01.08.2020) during the COVID-19 pandemic. Shielding was described as the requirement to not leave home and minimise all face-to-face contact. At our adult CF centre in London, there was a 50% reduction in requirement for IVAB, compared to the same period in 2019. We aimed to identify potential factors contributing to the reduced requirement of IVAB during shielding. Method: An 8-point patient questionnaire was given to 27 patients who had required ≥3 courses of IVAB in the year 2019. These were designed to identify percentage of patients shielding, percentage of patients starting a modulator, variation in adherence to regular medications, chest physiotherapy, and requirement to IVAB. Results: 70% response rate (n = 19). [Table Presented] Despite a 50% reduction in IVAB compared to the previous year, the majority of patients reported their requirement for IVAB remained the same (68%). There was no self-reported increase in adherence to regular medications or chest physiotherapy. The majority of patients felt their overall health status remained stable or improved (78%). During this period the majority of patients fully shielded (84%) and started Symkevi®/Kalydeco or Kaftrio®/Kalydeco (as part of a trial or compassionate use program) (84%). Conclusion: Increased adherence to regular medication and physiotherapy did not appear to be a factor in reducing the requirement for IVAB observed during the UK COVID-19 pandemic lockdown. Adherence to government shielding may have reduced exposure to community acquired infections and associated requirement for IVAB. Commencement of a modulator therapy was likely to have a positive impact on overall health and associated of reduction in requirement of IVAB.