Clinical trial to test success of Cystic Fibrosis lung infection treatment

March 27, 2012, University of Nottingham

Experts from Bristol and Nottingham are leading a major new national study to investigate whether intravenous antibiotics are effective in killing a common germ that causes dangerous complications in cystic fibrosis (CF) patients.

The team is hoping to find out if the treatment is more effective than traditional therapies in tackling , which causes a chronic destructive lung infection in and which cannot be eradicated unless it is caught in the early stages.

Dr Simon Langton Hewer, from University Hospitals Bristol NHS Foundation Trust, who is chief investigator of the study, said: "It's very exciting to have a clinical trial available to CF patients around the whole of the UK. This is the first CF trial for many years to be run in the UK and will answer one of the important questions affecting CF patients."

Professor Alan Smyth in The University of Nottingham's School of Clinical Sciences, a co-investigator in the TORPEDO clinical trial, said: "Children and adults with CF are now receiving intravenous antibiotics for Pseudomonas more and more often, with no good evidence that this is more effective. We want to see if intravenous antibiotics do work better than traditional oral treatment because oral treatment is easier to give at home and does not require a ."

Pseudomonas aeruginosa is a bacterium that lives in the environment, lurking in places such as sink drains. Most CF patients have chronic with the germ by their late teens. Oral and nebulised (inhaled) antibiotics have mainly been used to eradicate Pseudomonas, but are often only effective if the infection is caught in time.

Intravenous antibiotics are being used more often to treat the infection, however, there is no current clear scientific evidence that intravenous treatment is better than oral treatments. Intravenous treatment means that patients with CF need to spend up to two weeks in hospital in addition to the medication they may previously have been prescribed.

The new trial is funded with £1.5 million from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme and sponsored by University Hospitals Bristol NHS Foundation Trust. So far, 41 CF centres and clinics around the UK have signed up to the trial — coordinated from the Medicines for Children Research Network (MCRN) Clinical Trials Unit in Liverpool — with the aim of recruiting 280 volunteer CF patients.

Adele Whitford from Severn Beach near Bristol, whose daughter has cystic fibrosis, said: "We decided to take part in the trial because we want to help improve the care for cystic fibrosis patients. As a nurse, part of my job is to provide best evidence practice and without research being carried out you haven't got that evidence."

Zoë and Steve Elliott, of Mapperley Park, Nottingham, have two-year-old twins Alexander and Isobel who were both diagnosed with CF shortly after they were born. They say they didn't hesitate in getting the twins involved with the trial and hope the research will give parents of children with CF firm evidence of whether IV antibiotics really do offer the best treatment option.

Zoë said: "When we were invited on to the trial I was initially really surprised that this research hadn't already been done because in our experience IV antibiotics are generally perceived among parents of children with CF to be the best way of eradicating the infection. As a mum, if it's a toss-up between being at home with a nebuliser for three months or having your child in hospital having invasive treatment for two weeks I know what my gut instinct tells me — it's home every time. But it would be reassuring to have some firm evidence to allow us to make a more informed choice and that's why this research is long overdue."

Matthew Reed, Chief Executive of the Trust said: "Pseudomonas infection is a leading cause of lung damage in people with CF so it is important to find the most effective way to eradicate this bug and therefore help people with CF to live longer. We commend the team at Nottingham and Bristol for their initiative on this study and hope that suitable people with CF throughout the UK will agree to take part in this important piece of research. It is great to see so many UK CF centres (large and small) involved and we would encourage centres not yet taking part to sign up for the trial."

Patients with a new Pseudomonas aeruginosa infection which has been identified through a routine sample from the lungs are being invited on to the study and are given (at random) either two weeks of intravenous antibiotics and three months of nebulised antibiotics or three months of combined oral and nebulised treatment. They will then be followed up for a further 15 months through routine clinic visits to assess whether the germ has been eradicated and stays away for at least a year.

If the trial finds that are more successful in treating the infection, this will form the basis of national guidelines on standard medical practice and mean that patients have access to a more effective treatment.

If intravenous treatment doesn't work as well as traditional methods, it could spare patients the inconvenience of hospitalisation, the trauma of having an intravenous cannula inserted — a particular problem for many children suffering from CF — and the upset of missing school or work for two weeks.

Explore further: Early cystic fibrosis lung disease detected by bronchoalveolar lavage and lung clearance index

More information: The trial is open to adults and children with CF (excluding babies under one month old) and further information about the trial and how to participate can be found at

Related Stories

Early cystic fibrosis lung disease detected by bronchoalveolar lavage and lung clearance index

January 27, 2012
The lung clearance index (LCI) is a sensitive non-invasive marker of early lung disease in young children with cystic fibrosis (CF), according to a new study from Australian researchers.

Bacterial infection alone not an indicator of poor lung function in adolescents with CF

May 16, 2011
Children with cystic fibrosis (CF) who have poor lung function early in life are more likely also to have poor lung function in adolescence, regardless of whether they are exposed to a common infection caused by the bacteria ...

Cystic fibrosis drug reverses genetic abnormality in the CF mutation

November 28, 2011
The Lung Institute of WA (LIWA) has recently made a breakthrough in the search for a drug to improve the quality of life of patients with Cystic Fibrosis (CF).

Recommended for you

Creation of synthetic horsepox virus could lead to more effective smallpox vaccine

January 19, 2018
UAlberta researchers created a new synthetic virus that could lead to the development of a more effective vaccine against smallpox. The discovery demonstrates how techniques based on the use of synthetic DNA can be used to ...

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.