Types of Antibiotics Used to Treat Cystic Fibrosis Infections

Reviewed by: HU Medical Review Board | Last reviewed: May 2022

Cystic fibrosis (CF) causes thick, sticky mucus to build up in the airways, creating a breeding ground for infections. When such an infection is caused by a bacteria, doctors prescribe antibiotics to kill or knock back the infection. Antibiotics do not kill viruses like the flu or fungal infections caused by yeasts or molds.

Many people with CF take antibiotics daily to prevent new lung infections, exacerbations, or reduce the strength of a long-term infection. This helps maintain the person’s lung function (ability to breathe) by slowing or stopping the permanent damage that lung infections cause to the airways.

How are antibiotics given?

For daily treatments, the CF Foundation recommends that inhaled antibiotics be used last, after a bronchodilator, mucus thinners, and airway clearance techniques.1 Using the drugs in this order helps the antibiotics reach deeper into the lungs.

Some people with CF also take antibiotics in a tablet form by mouth (orally). With a lung exacerbation (lung attack), many receive antibiotics through an IV (intravenous) in addition to inhaled and oral antibiotics.

What types of antibiotics are used for cystic fibrosis infections?

Thousands of antibiotics exist, each tailored to fight certain types of bacterial infection. They come in tablet, IV, or aerosolized form.

In order to prescribe the right antibiotic to fight the infection, the doctor will take a sputum sample and test it to see what type of bacterial infection you have. Here are some of the most commonly prescribed antibiotics for CF and the bacteria each treat:

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Bacteria: Staphylococcus aureas (Staph)

Antibiotic familyMedication name
Penicillins
  • Amoxicillin and clavulanic acid (Augmentin®)
  • Dicloxacillin
  • Ticarcillin and clavulanic acid (Timentin®)
  • Piperacillin and tazobactam
Cephalosporins
  • Cephalexin and cefdinir
  • Cefuroxime
Sulfa
  • Sulfamethoxazole and Trimethoprim (Bactrim®)
Macrolides
  • Erythromycin, clarithromycin, and azithromycin
Tetracyclines
  • Tetracycline, doxycycline, minocycline, and tigecycline
Others
  • Vancomycin
  • Imipenem/cilastatin and Meropenem

Bacteria: Pseudomonas (P. aeruginosa)

Antibiotic familyMedication name
Penicillins
  • Ticarcillin and clavulanic acid (Timentin®)
  • Piperacillin and tazobactam (Zosyn®)
Cephalosporins
  • Cefepime
  • Ceftazidime
Macrolides
  • Azithromycin
Quinolones
  • Ciprofloxacin, levofloxacin
Others
  • Imipenem/cilastatin and Meropenem
  • Aztreonam (Cayston)
  • Tobramycin, Amikacin and Gentamicin
  • Colistimethate/Colistin®

Bacteria: Methicillin-Resistant Staphylococcus aureus (MRSA)

Antibiotic familyMedication name
Sulfa
  • Sulfamethoxazole and Trimethoprim (Bactrim®)
Others
  • Vancomycin
  • Linezolid

Bacteria: Burkholderia cepacia (B. cepacia)

Antibiotic familyMedication name
Tetracyclines
  • Tetracycline, doxycycline, minocycline, and tigecycline (treats some strains)
Sulfa
  • Sulfamethoxazole/Trimethoprim
Cephalosporins
  • Ceftazidime
Other
  • Imipenem/cilastatin and Meropenem

What are side effects of antibiotics?

Bacteria sometimes respond to antibiotics by changing (mutating) so that the drug no longer weakens or kills them. This process is called antibiotic resistance. As antibiotic resistance develops, higher doses of the same antibiotic or different antibiotics are needed to get the same result.2

Other side effects of antibiotics vary depending on the drug, its dosage, and its delivery method (oral, IV, or inhaled). Gastrointestinal issues are especially common since antibiotics often kill the bacteria you don't want along with the gut flora that helps you digest food causing diarrhea, nausea, or vomiting.

Other common side effects of antibiotics include headaches, jaundice, muscle aches, weakness, yeast infections, and rash. Again, the side effects vary greatly from person to person and between antibiotics.1