Inhaled AntibioticsInhaled antibiotics are used to fight or control bacteria that cause lung infections. They should not be used to treat infections caused by viruses (such as the flu) or types of fungi, which include yeasts and molds. Your CF care team will use the results of a sputum culture to see if you need to take an inhaled antibiotic. Inhaled antibiotics go right to where they are needed — deep into the small airways in your lungs.
The buildup of thick, sticky mucus in the lungs makes people with cystic fibrosis more likely to develop bacterial infections that can last for short periods of time (known as acute infections or exacerbations) or for many years. Inhaled antibiotics should be taken last, after bronchodilators (if you take them), mucus thinners, and airway clearance techniques, so your lungs will be as clear of mucus as possible. This allows the antibiotics to reach deep into your lungs to treat the bacteria that cause infection. Below is a list of bacteria common among people with CF, along with the antibiotics that are commonly prescribed to treat them. This list is not meant to cover all bacteria and/or treatment therapies. Please consult your care team for more information and to discuss your particular needs. |
Common Bacteria Among People with CF
Staphylococcus aureus (Staph)
Pseudomonas (P. aeruginosa)
- Colistimethate/Colistin®
Pseudomonas (P. aeruginosa)
- Aminoglycosides: Tobramycin, Amikacin, Gentamicin
- Aztreonam
- Colistimethate/Colistin®
Additional Information
How to administer antibiotics:
To prevent antibiotic resistance, people typically alternate between taking aztreonam and tobramycin. For example, people take aztreonam for 28 days and then switch to tobramycin for another 28 days. Some may alternate one medication by taking 28 days on and 28 days off.
Aztreonam and tobramycin inhalation solution are administered with a nebulizer. There are several different types of nebulizer and compressor devices, depending on which medication is being administered. With most types of nebulizers, the drug is put in a clean nebulizer cup and attached to a small air compressor. The compressor blows air through the nebulizer cup, which creates a mist that you inhale through a mouthpiece. Certain aerosol medications require you to use specific devices. Use only recommended nebulizers. Your CF care team can offer suggestions and show you how to use these devices correctly.
What to expect after taking Antibiotics:
Antibiotics typically begin working 48 to 72 hours after you begin taking them. It may take a day or so before you start to feel better. As the antibiotics work to break up the mucus, coughing may increase, which is why some people feel worse before they feel better.
You may experience side effects when you take any medication, including antibiotics. When discussing any new medications or changes in dosages for medications you are already taking, be sure to ask your care team about:
Where Are These Medications Available?
Antibiotics are typically available at retail pharmacies and mail-order pharmacies. A specialty pharmacy fills prescriptions for drugs that are unavailable at retail pharmacies. Medications from specialty pharmacies often need to be handled and stored specially and delivered quickly.
Insurance plan coverage for some antibiotics can vary. For antibiotics that are specifically indicated for CF treatment, most insurance providers should provide coverage. For antibiotics that are not specifically indicated for CF treatment, insurance coverage may be more difficult to arrange. For example, although the antibiotic colistimethate (Colistin®) is often prescribed as an inhaled treatment for P. aeruginosa, it is considered an injectable antibiotic. Because it is not specifically indicated to be used in that way, coverage may be declined by insurers. Check with your insurance provider to ensure that the antibiotic is covered and what your out-of-pocket expenses may be.
You can also contact the Cystic Fibrosis Foundation Compass, a free, personalized service that can help you with insurance, financial, legal, and other issues. Dedicated Compass case managers can assist in coordinating benefits or providing information about benefits offered under your plans. Contact Compass at: 844-COMPASS (844-266-7277) or compass@cff.org.
To prevent antibiotic resistance, people typically alternate between taking aztreonam and tobramycin. For example, people take aztreonam for 28 days and then switch to tobramycin for another 28 days. Some may alternate one medication by taking 28 days on and 28 days off.
Aztreonam and tobramycin inhalation solution are administered with a nebulizer. There are several different types of nebulizer and compressor devices, depending on which medication is being administered. With most types of nebulizers, the drug is put in a clean nebulizer cup and attached to a small air compressor. The compressor blows air through the nebulizer cup, which creates a mist that you inhale through a mouthpiece. Certain aerosol medications require you to use specific devices. Use only recommended nebulizers. Your CF care team can offer suggestions and show you how to use these devices correctly.
What to expect after taking Antibiotics:
Antibiotics typically begin working 48 to 72 hours after you begin taking them. It may take a day or so before you start to feel better. As the antibiotics work to break up the mucus, coughing may increase, which is why some people feel worse before they feel better.
You may experience side effects when you take any medication, including antibiotics. When discussing any new medications or changes in dosages for medications you are already taking, be sure to ask your care team about:
- Any potential side effect
- Which side effects might be more serious than others
- How long they might last
- When to talk to your care team if side effects don't go away or if they interfere with your quality of life
Where Are These Medications Available?
Antibiotics are typically available at retail pharmacies and mail-order pharmacies. A specialty pharmacy fills prescriptions for drugs that are unavailable at retail pharmacies. Medications from specialty pharmacies often need to be handled and stored specially and delivered quickly.
Insurance plan coverage for some antibiotics can vary. For antibiotics that are specifically indicated for CF treatment, most insurance providers should provide coverage. For antibiotics that are not specifically indicated for CF treatment, insurance coverage may be more difficult to arrange. For example, although the antibiotic colistimethate (Colistin®) is often prescribed as an inhaled treatment for P. aeruginosa, it is considered an injectable antibiotic. Because it is not specifically indicated to be used in that way, coverage may be declined by insurers. Check with your insurance provider to ensure that the antibiotic is covered and what your out-of-pocket expenses may be.
You can also contact the Cystic Fibrosis Foundation Compass, a free, personalized service that can help you with insurance, financial, legal, and other issues. Dedicated Compass case managers can assist in coordinating benefits or providing information about benefits offered under your plans. Contact Compass at: 844-COMPASS (844-266-7277) or compass@cff.org.