Report of the UK Cystic Fibrosis Trust Antibiotic Working Group

• If a facemask is used the face should be washed after nebulisation [D].• The pros and cons of continuing nebulised antibiotic treatment during pregnancy should beindividually assessed [D].5.12.9 Recommendations on nebuliser maintenance• Patients should be instructed to carefully follow manufacturers instructions for cleaningnebulisers [D].• An electrical compressor should have an inlet filter, which should be changed according tomanufacturers instructions [D].• Hospitals issuing nebuliser/compressor systems should arrange for their regular servicing. Patientswho have purchased their own nebuliser/compressor systems should have their equipment servicedby the hospital where they attend for their CF care. The I-neb® is the property of themanufacturer. Repairs and replacement consumables are dealt with directly between the patientand company [D].5.13 Environmental safety5.13.1 IntroductionThere is no published evidence to support or refute concern that nebulised antibiotics may be a healthhazard to medical personnel or the hospital and home environment. It has been suggested thataerosolised antibiotics may encourage the emergence of resistant organisms, particularly on intensivecare units. Patients, however, usually stop nebulised antibiotic treatment when receiving intravenousantibiotics in hospital. At home, patients should nebulise their antibiotics in a separate room. Theydo not need to filter their exhaled antibiotics for safety reasons, although they may wish to do so toeliminate the odour and protect surrounding furniture from sticky deposits. If for practical reasons itis not possible to nebulise in a separate room filters are recommended.5.13.2 Recommendations on environmental safety• In hospital the local Trust policy should be followed [D].• In hospital, a nebuliser should be fitted with a high efficiency breathing filter on the expiratoryport, to prevent environmental contamination. For I-neb® (section 5.16) [D].• It is advisable for patients to receive nebulised antibiotics in a separate area from other patients[D].• If the patient has a sibling with cystic fibrosis the use of a filter is mandatory [D].• Mothers with CF who have young children should use a filter when nebulising antibiotics [D].Cystic Fibrosis Trust 5.13March 2009