Report of the UK Cystic Fibrosis Trust Antibiotic Working Group

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Amikacin intravenouslyAge Dose Frequency1 month–18 years 10 mg/kg (max 500 mg) 8 hourlyAdult 7.5 mg/kg (max 750 mg) 12 hourlyPreparationsAdministrationSide-effectsNotes100 mg and 500 mg in 2 ml.Slow intravenous injection.Nephrotoxicity and ototoxicity.Ensure adequate hydration and normal renal function at the start of therapy. Reduce dosage in renal impairment.Aim for trough level of 12 years 5 g (total daily dose can be increased to 20g) 8–12 hourlyPreparationsAdministrationSide-effectsNotes2, 3 and 5 g vials available.Intravenous infusion over 30 mins.Can cause electrolyte disturbance.Adjust dose in renal impairment. Not available in the UK. May be imported on a named patient basis.Cystic Fibrosis Trust 8.8.6March 2009
8.9 Inhaled anti-pseudomonal antibioticsThere are currently three preparations licensed for the treatment of P.aeruginosa in cystic fibrosis,colistin (Colomycin® and Promixin®) and preservative free tobramycin solution for inhalation (TSIor TOBI®). Colistin is the drug of first choice for nebulised use as resistance rarely occurs even afterprolonged use. In combination with oral ciprofloxacin it is the treatment of choice for earlyeradication of new P.aeruginosa infections (section 5.2.2). Nebulised colistin is widely used as longtermtreatment for patients chronically infected with P.aeruginosa (section 5.3.2).Colistin inhaledAge Dose Frequency1 month–2 years 500,000–1 million units 12 hourlyOver 2 years & adult 1–2 million units* 12 hourlyPreparations500,000 unit, 1 million unit and 2 million unit vials.Administration Details in sections 5.7 and 5.8.Side-effectsBronchospasm – may be prevented by an inhaled bronchodilator. The tendency to bronchoconstriction can bereduced by the use of a more isotonic solution. Transient sensory disturbances.Notes* Many CF centres use 1MU bd for children
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4. ORAL ANTIBIOTICS IN CYSTIC FIBRO
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7. OTHER INFECTIONS7.1 Management o
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GRADING SCHEME FOR LEVELS OF EVIDEN
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SUMMARY•All young children with c
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In 1989 the Copenhagen centre recom
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These bacteria can be harmless comm
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2.7 Clinical relevance of in vitro
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17. Macia MD, Blanquer D, Togores B
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3.1 Introduction3. IDENTIFICATION O
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Table 2: Laboratory techniques and
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20. Hoppe JE, Theurer MU, Stern M.
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4.2.4 Recommendations for treatment
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4.5 Use of oral antibiotics at time
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groups in terms of the chronic use
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5.1 Introduction5. NEBULISED ANTIBI
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5.5 Nebulised antibiotics to preven
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5.10.2 Recommendations for administ
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• If a facemask is used the face
Page 42 and 43: 5.16 Nebuliser/compressor systems f
Page 44 and 45: 19. Ratjen F, Walter H, Haug M, Mei
Page 46 and 47: 69. Pitchford KC, Corey M, Highsmit
Page 48 and 49: outcome between active and placebo
Page 50 and 51: Drug Route Age/weight DoseFrequency
Page 52 and 53: much sooner. A minimum of 10-14 day
Page 54 and 55: 6.8 References1. Armstrong DS, Grim
Page 56 and 57: 7. OTHER INFECTIONS7.1 Management o
Page 58 and 59: 7.2 Respiratory infection with meti
Page 60 and 61: Table 7.2 Published data on eradica
Page 62 and 63: 7.4.2 Recommendations• Given the
Page 64 and 65: although not all authors have found
Page 66 and 67: Table 7.3 Drugs for treatment of My
Page 68 and 69: 7.9.2 Diagnosis of ABPAThe Cystic F
Page 70 and 71: • It is important to assess the c
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Page 74 and 75: 57. Ballestero S, Virseda I, Escoba
Page 76 and 77: 107. Deerojanawong J, Sawyer SM, Fi
Page 78 and 79: 155. Stevens DA, Moss RB, Kurup VP,
Page 80 and 81: 8. PHARMACOPOEIAOriginally based on
Page 82 and 83: 8.3 Treatment of more severe exacer
Page 84 and 85: Co-amoxiclav orallyAge Dose Frequen
Page 86 and 87: Cefotaxime intravenouslyAge Dose Fr
Page 88 and 89: 8.7 Treatment of Pseudomonas aerugi
Page 90 and 91: 8.8.3 Other ß-lactam antibioticsTh
Page 94 and 95: 8.10 Chronic oral anti-pseudomonal
Page 96 and 97: TemocillinAge Dose Frequency>12year
Page 98 and 99: Liposomal Amphotericin (“Ambisome
Page 100 and 101: 9. ANTIBIOTIC-RELATED ALLERGIES AND
Page 102: I N F O R M A T I O NCystic Fibrosi
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Report of the UK Cystic Fibrosis Trust Antibiotic Working Group

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