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Poster Presentation: Retrospective chart review of treatment for acute bronchopulmonary aspergillosis in patients with cystic fibrosis
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Poster Presentation: Retrospective chart review of treatment for acute bronchopulmonary aspergillosis in patients with cystic fibrosis

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Authors: Danielle Cassidy, Pharm.D., BCPS, Laney Jorgenson, Pharm.D., & Jennifer Hamner, Pharm.D. …

Authors: Danielle Cassidy, Pharm.D., BCPS, Laney Jorgenson, Pharm.D., & Jennifer Hamner, Pharm.D.
Audience: Pediatric Pharmacy Advocacy Group (PPAG) Conference in Balitmore, MD October 2008; Children's Hospital Colorado medical staff January 2009.

Published in: Health & Medicine

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  • 1. A Retrospective Review of Treatment for Allergic Bronchopulmonary Aspergillosis in Patients with Cystic Fibrosis Affiliated with Danielle Cassidy, Pharm.D., Laney Jorgenson, Pharm.D., & Jennifer Hamner, Pharm.D. University of Colorado Denver The Children’s Hospital, Denver, CO Background Patient Characteristics Results Limitations (n=50)• Patients with cystic fibrosis Treatment Regimens Treatment Tolerance 1) Missing or incomplete charting of (CF) are at increased risk for Methods Gender (n) parameters collected multiple infections, including Male 46 Treatment Patients Dose Hospital Out- • Retrospective medical chart (n) (mg) Treatment patient 2) Improper chart interpretation Aspergillus fumigatus. Female 4 review Mean (days) Rx (n)• The presence of Aspergillus • Study period 10 years (01/97- Age (years) 3) Small sample size leads to a constellation of [range] Mean 10/07) Mean 15.2 ± 6.2 [range] 4) Unable to determine contribution symptoms referred to as • Reviewed and approved by of treatment response from other Weight (kg) allergic bronchopulmonary the Colorado Multiple Prednisone 23 (46%) 25.6 10.6 15 Mean 59.4 ± 4.1 [10-30] [5-21] standard CF therapies aspergillosis (ABPA). Institutional Review Board• ABAP may lead to a faster Admission Symptoms (%) • Informed consent was not Itraconazole 42 (84%) 160.71 11.79 32 decline in pulmonary function. required Worsening Cough 80 [100-300] [1-30]• Current treatment guidelines Increased sputum 42 Voriconazole 13 (26%) 138.45 8.77 7 recommend corticosteroids for productions [100-200] [1-14] all ABAP exacerbations, and SOB 40 Amphotercin 2 (4%) 2 5.5 2 the addition of itraconazole for New/increased 18 (nebulized) [4-7] poor corticosteroid responders pulmonary infiltrates or corticosteroid-dependent Fatigue 16 Azathioprine 1 (2%) 250 5 1 Conclusions patients. Decreasing PFT’s 14 1) Novel treatment regimens utilized at TCH include itraconazole, voriconazole, Primary Outcomes Therapeutic Outcomes nebulized amphotercin, and azathioprine. 1) Characterization of 2) Therapeutic outcomes standard and novel ABPA associated with both treatment treatment regimens regimens led to improvement in Study Objectives 2) Describe therapeutic FEV1, a decrease in serum IgE, outcomes of these and complete resolution of• To describe both standard and treatment regimens symptoms. novel treatment regimens for a) FEV1 3) Therapy was generally well ABPA in patients with CF at tolerated with only 14% of TCH. b) IgE c) Changes in symptoms Range Range patients experiencing ADEs.• Evaluate the therapeutic 3-4208 3-5966 outcomes associated with 4) Additional studies are warranted d) Adverse drug events SD ±23 standard and novel treatment to further define the role of these (ADE) regimens. novel therapies.