Report of the UK Cystic Fibrosis Trust Antibiotic Working Group

SUMMARY•All young children with cystic fibrosis (CF) identified by newborn screening, or diagnosedclinically, should be started on continuous anti-staphylococcal antibiotic prophylaxis withflucloxacillin (continued until 3 years).•Samples of respiratory secretions (sputum or cough swab) should be sent for bacterial culturefrom CF patients at every medical contact. Approved laboratory techniques for CF organismsshould be followed and the results acted on promptly.•When Pseudomonas aeruginosa is found in respiratory secretions in a CF patient who waspreviously free of P.aeruginosa or who has never had the organism, then they should receive anappropriate eradication regimen in a timely fashion.•All CF patients with chronic pulmonary infection with P.aeruginosa should have long termnebulised anti-pseudomonal therapy, unless contra-indicated.•A six month trial of oral azithromycin should be considered in patients who are deteriorating onconventional therapy, irrespective of their infection status.•Pulmonary exacerbations in CF patients should be treated promptly with oral or intravenousantibiotics. Intravenous treatment must be used if the patient’s condition does not improve withoral treatment.•Support with nutrition and physiotherapy should be intensified during exacerbations. Homeintravenous treatment is useful for some but this should be tailored to the needs of the patientand family.Cystic Fibrosis Trust SummaryMarch 2009