Cystic fibrosis and outpatient treatment with parenteral antibiotics in children.

Despite recent key insights into the pathogenesis of cystic fibrosis, the treatment of patients suffering from this disease remains largely symptomatic. Control of respiratory infections is a vital part of patient management, involving daily physiotherapy and administration of mucolytics, bronchodilators and oral or intravenous antibiotics as necessary. For those patients requiring frequent courses of intravenous antibiotics, home treatment appears preferable to repeated hospital admissions. A home care programme for cystic fibrosis has been running at the Wilhelmina Children's Hospital in Utrecht since 1991, with the aid of two specialist nurses to provide support and instruction for children and their parents. While parents of younger children were often reluctant to accept the increased responsibility for their child's care, children who had received a period of home treatment were enthusiastic about its use and eager for the programme to continue. However, anxiety of patients and parents and medical instability may be of such importance in certain circumstances that treatment is not always given at home, even after former successful periods of home care.