Antibiotics are used to prevent and treat bacterial lung infections in people with cystic fibrosis. The type of antibiotic you receive depends on what type of infection you have or are trying to prevent.
Cystic fibrosis is a genetic disease in which your body produces too much mucus, digestive enzymes (proteins that help your body digest food), and sweat.
It’s caused by a mutation in a gene that codes for a protein called the cystic fibrosis transmembrane conductance regulator (CFTR).
The buildup of mucus in the lungs of people with cystic fibrosis can trap bacteria and other microorganisms. Repeated bacterial infections are one of the
Antibiotics are often combined with new treatment options like CFTR modulators. Thanks to advances in cystic fibrosis treatment, about half of people with it now live past 40 years old. This rate will likely continue to rise.
Read on to learn how antibiotics are used as a treatment for cystic fibrosis and which antibiotics are most prescribed.
Antibiotics are a group of medications that kill bacteria. The
- preventing new infections
- reducing flare-ups of current infections
- managing long-term infections
Antibiotics are necessary whenever an infection has caused a noticeable decline in lung function and symptoms such as shortness of breath or wheezing. Flare-ups of bacterial infections or new infections are often treated with oral or intravenous (IV) antibiotics.
The Cystic Fibrosis Foundation recommends using inhaled antibiotics after bronchodilators, mucus thinners, and airway clearance techniques to help the medication better reach the deep parts of your lungs.
There are many types of antibiotics available. Doctors and other healthcare professionals prescribe antibiotics based on the specific strand of bacteria you have and whether your infection is short term or long term. The severity of your condition and the specific organism will determine if treatment will be most effective orally, IV, or inhaled.
The
Here’s a look at some of the most common antibiotics for these strands of bacteria.
Staphylococcus aureus
The
| Drugs | Dosage (milligrams per kilogram per day) | Route | Times per day | Length (weeks) |
|---|---|---|---|---|
| Flucloxacillin | 100 | oral | 3 to 4 | 2 to 4 |
| Fusidic acid | 25 to 50 | oral, IV | 2 to 3 | 2 to 4 |
| Rifampicin | 15 to 20 | oral, IV | 2 | 2 to 4 |
The Cystic Fibrosis Foundation lists the following combinations of antibiotics as the most common for treating S. aureus infection:
| Type | Route |
|---|---|
| Amoxicillin and clavulanic acid | oral |
| Dicloxacillin | oral |
| Cephalexin, cefdinir | oral |
| Cefuroxime | oral |
| Sulfamethoxazole and trimethoprim | oral |
| Tetracycline, doxycycline, minocycline, tigecycline | oral, IV, intramuscularly (injection through a muscle) |
| Clindamycin | oral, IV |
| Linezolid | oral, IV |
| Nafcillin, oxacillin | IV |
| Piperacillin with tazobactam | IV |
| Cefazolin | IV |
| Meropenem, imipenem/cilastatin, doripenem, meropenem-vaborbactam, ertapenem | IV |
| Vancomycin | IV |
P. aeruginosa
The
| Drugs | Route |
|---|---|
| Ciprofloxacin/tobramycin or colomycin | oral/inhaled |
| Ceftazidime | IV |
| Meropenem | IV |
| Colomycin and amikacin or tobramycin | inhaled |
The Cystic Fibrosis Foundation lists the following as the most common antibiotic combinations for P. aeruginosa infection:
| Type | Route |
|---|---|
| Sulfamethoxazole with trimethoprim | oral |
| Doxycycline, minocycline | oral |
| Azithromycin | oral, IV |
| Ciprofloxacin, levofloxacin | oral, IV |
| Linezolid | oral, IV |
| Rifampin, combined with other active ingredients | oral, IV |
| Clindamycin | oral, IV |
| Tobramycin, amikacin, gentamicin | IV, inhaled |
| Aztreonam | IV, inhaled |
| Colistimethate | IV, inhaled |
| Piperacillin and tazobactam | IV |
| Ceftazidime, Ceftazidime-avibactam | IV |
| Cefepime | IV |
| Ceftolozane-tazobactam | IV |
| Meropenem, meropenem-vaborbactam, imipenem with cilastatin, doripenem | IV |
| Vancomycin | IV |
| Ceftaroline | IV |
| Doxycycline, tigecycline | IV |
| Mupirocin | topical |
The next step after you take antibiotics depends on whether you’re taking them for a chronic infection or a sudden infection.
A doctor will want to monitor how well you’re responding to the antibiotic so they can decide if you may need another type of treatment. If oral antibiotics aren’t effective, you may need antibiotics administered through an IV line.
Antibiotics for chronic infections are often inhaled. Inhaling antibiotics instead of taking them orally or through an IV line can help minimize side effects and increase the amount of the antibiotic that’s delivered straight to your lungs.
Inhaled antibiotics fail to eradicate P. aeruginosa infection in about
Antibiotics are important for preventing and treating infections, but they can cause side effects. Some of their potential side effects include:
Bacteria can sometimes mutate so that antibiotics no longer affect them. This is called antibiotic resistance. The
Doctors can decrease your chance of developing antibiotic resistance by tailoring your treatment to the specific type of bacteria you have. If you don’t respond to treatment, you may need to change your dosage or change your type of antibiotic.
It’s best to follow directions provided by a healthcare professional and to finish the course of prescribed antibiotics even if you start to feel better to prevent antibiotic resistance.
Researchers continue examining new antibiotics for treating infections in people with cystic fibrosis. There are relatively few inhaled antibiotics currently available. Researchers are continuing to look at new drugs that might help prevent or treat lung infections.
Some of the clinical trials currently underway or are currently recruiting include:
- inhaled sodium nitrite as an antimicrobial for cystic fibrosis
- Trikafta/Kaftrio and P. aeruginosa
- cefiderocol pharmacokinetics in adults with cystic fibrosis
- imipenem/cilastatin/relebactam pharmacokinetics, safety, and outcomes in adults and adolescents with cystic fibrosis
- DPI-Tobra-Kind Cyclops® in children with cystic fibrosis
Here are some frequently asked questions people have about antibiotics and cystic fibrosis.
Which antibiotic will my doctor recommend?
Many different types of antibiotics are used to treat and prevent infections in people with cystic fibrosis. The type of antibiotics you take depends on which type of infection you have, which antibiotics you’ve already tried, and whether your infection is chronic.
Do I need to take antibiotics if I’m taking a CFTR modulator?
More long-term studies are needed to see if it’s safe for people taking CFTR modulators to stop taking daily antibiotic therapy. Currently, it’s generally recommended to continue your current treatment regimen.
What are S. aureus and P. aeruginosa infections?
S. aureus and P. aeruginosa are the two most common bacterial infections in people with cystic fibrosis.
S. aureus is
P. aeruginosa is commonly found in
Antibiotics are used to treat and prevent lung infections in people with cystic fibrosis. Antibiotics are administered orally, through an IV line, or inhaled. The type of antibiotic a doctor recommends depends on which type of infection you have.
It’s important to follow a doctor’s instructions for any antibiotics you’re prescribed. Not taking antibiotics as prescribed can increase the chance that they’ll not be as effective or increase your chance of antibiotic resistance.