The Foundation is funding the development of a wide range of treatments to address infections. In addition, researchers are exploring when to treat, how long to treat, and what medications to use. They are especially interested in how best to use antibiotics so they are most effective.
The STOP 2 trial found that in people with CF who experienced a pulmonary exacerbation, 10 days of IV antibiotic treatment was no worse than 14 days of antibiotic treatment when comparing differences in lung function improvement among those who responded early to treatment. Also, among those slower to respond, 21 days of treatment was not significantly better than 14 days of antibiotic treatment when it comes to lung function improvements.
The upcoming STOP-PEDS 2.0 trial is under development and aims to continue to study the use of oral antibiotics for outpatient pulmonary exacerbations in children with CF. The STOP 360 trial will compare the use of one IV antibiotic versus two IV antibiotics to treat certain infections in adults.
To address drug-resistant bacteria, the Foundation is supporting clinical research into unique treatments — such as gallium, nitric oxide, and bacteriophage therapy — that work differently than typical antibiotics.
To grow, bacteria rely on some processes that require iron. If gallium — an atom nearly identical to iron — is used instead, it can disrupt these processes. For example, gallium has been shown to kill antibiotic-resistant strains of Pseudomonas in laboratory research. Intravenous (IV) gallium and an inhaled version are being tested in clinical trials in people with CF.
Inhaled nitric oxide is being tested in clinical trials as a treatment for Pseudomonas and NTM. Nitric oxide is a molecule produced by our bodies that kills bacteria, breaks up biofilms, and improves the movement of cilia — hair-like structures that help move mucus out of the lungs.
Bacteriophage (phage) therapy is an experimental treatment that uses specialized viruses to kill specific bacterial strains. Currently, people with CF can only access phage treatment in the U.S. through a clinical trial or by using the Food and Drug Administration emergency Investigational New Drug process, which allows the use of experimental therapies for life-threatening conditions. We are supporting several studies to explore the feasibility of phage therapy as a treatment for drug-resistant infections.
Other potential treatments that are being tested include:
- New formulations and new uses of existing antibiotics
- A drug that would protect the inner ear and prevent hearing loss caused by aminoglycosides — commonly used antibiotics such as tobramycin and amikacin
The Foundation also is supporting research into fungal infections, especially those caused by Aspergillus fumigatus. This type of fungus can cause complications when it becomes invasive or when it causes an allergic reaction called allergic bronchopulmonary aspergillosis (ABPA). A large-scale study into Aspergillus infections is being planned.
To learn more about key infection research priorities including NTM, Aspergillus, and phage therapy, you can read the Infection Research Handout or watch the webinar, “Research Overview: Infections.” The webinar, hosted on Aug. 25, 2020, brought together research experts and members of the Infection Research Initiative Steering Committee to discuss the latest updates in infection research.