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Types of Antibiotics Used to Treat Cystic Fibrosis Infections

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 pill form by mouth (orally) every day. 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. Some come in pill, IV, or aerosolized form, while others only come in pills. Tobramycin and aztreonam are two antibiotics that only appear in inhaled form since these are made specifically for people with CF.

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:

Bacteria: Staphylococcus aureas (Staph)

Antibiotic family Medication name
Penicillins
  • Amoxicillin and clavulanic acid (Augmentin®)
  • Cloxacillin and dicloxacillin
  • Ticarcillin and clavulanic acid (Timentin®)
  • Cephalosporins
  • Cephalexin, cefdinir, cefprozil, and cefaclor
  • Cefuroxime
  • Sulfa
  • Sulfamethoxazole and Trimethoprim (Bactrim®)
  • Erythromycin/sulfisoxazole
  • Macrolides
  • Erythromycin, clarithromycin, and azithromycin
  • Tetracyclines
  • Tetracycline, doxycycline, minocycline, and tigecycline
  • Others
  • Vancomycin
  • Imipenem and Meripenem
  • Colistimethate/Colistin®
  • Bacteria: Pseudomonas (P. aeruginosa)

    Antibiotic family Medication name
    Penicillins
  • Methicillin, oxacillin, and nafcillin
  • Cabenicillin, ticarcillin, piperacillin, mezlocillin, and azlocillin
  • Ticarcillin and clavulanic acid (Timentin®)
  • Piperacillin and tazobactam (Zosyn®)
  • Cephalosporins
  • Cephalexin, cefdinir, cefprozil, and cefaclor
  • Cefepime
  • Sulfa
  • Sulfamethoxazole and Trimethoprim (Bactrim®)
  • Sulfa
  • Sulfamethoxazole and Trimethoprim (Bactrim®)
  • Macrolides
  • Erythromycin, clarithromycin, and azithromycin
  • Quinolones
  • Ciprofloxacin, levofloxacin
  • Others
  • Imipenem and Meripenem
  • Aztreonam (Cayston)
  • Colistimethate/Colistin®
  • Bacteria: Methicillin-Resistant Staphylococcus aureus (MRSA)

    Antibiotic family Medication name
    Sulfa
  • Sulfamethoxazole and Trimethoprim (Bactrim®)
  • Others
  • Vancomycin
  • Linezolid
  • Bacteria: Burkholderia cepacia (B. cepacia)

    Antibiotic family Medication name
    Tetracyclines
  • Tetracycline, doxycycline, minocycline, and tigecycline (treats some strains)
  • Bacteria: Nontuberculous Mycobacteria (NTM)

    Antibiotic family Medication name
    Linezolid (treats some strains)
  • Zyvox
  • 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

    Written by: Jessica Johns Pool | Last reviewed: September 2019
    1. Cystic Fibrosis Foundation. Antibiotics. Available at: https://www.cff.org/Life-With-CF/Treatments-and-Therapies/Medications/Antibiotics. Accessed 6/3/2019.
    2. Elborn JS. Cystic fibrosis. Lancet. 2016;388:2519-31. doi.org/10.1016/ S0140-6736(16)00576-6.