Inhalation therapy in cystic fibrosis.

Inhalation therapy can be divided into two types, intermittent aerosol therapy which 
is used to administer medications over brief periods and mist tent 
therapy which is used for prolonged periods of treatment. The present 
state of knowledge of the basic defect of cystic fibrosis makes 
it impossible to give hard and fast guide lines for the 
use of inhalation therapy. Much depends on the individual experience of 
the physician and the degree of pulmonary involvement of the individual 
patient. Response to bronchodilators can be assessed relatively easily, assessment of 
mucolytics and antibiotics is difficult. Antibiotics can be useful in helping 
to clear infection in those patients with early disease, as judged 
by clearing of pathogens from the cough swab or sputum. In 
patients with chronic cough and large volumes if purulent sputum with 
positive culture from gram negative bacteria, the cultures never become negative 
and only in the occasional patient can definite clinical benefit be 
claimed. A few severely ill patients have dramatically improved when this 
therapy has been introduced, and the patients are convinced of the 
benefit of this treatment. It is of course impossible in this 
disease, with such a varying clinical course, to prove scientifically that 
the inhalation therapy was the reason for this improvement. 