Table 3. Antimicrobial agents commonly used against acute pulmonary exacerbations in cystic fibrosis patients.a .
| Bacterium | Antimicrobial agent | Dose, mg/kg/day | Intervals and route |
|---|---|---|---|
| Staphylococcus aureus | Cephalexin Cefadroxil Cefuroxime Clarithromycin Clindamycin Amoxicillin + Clavulanic acid Sulfamethoxazole/trimethoprim Oxacillin Vancomycind Teicoplanind Linezolidd Tigecyclined |
50-100 (max, 4 g/day) 30 (max, 4 g/day) 20-30 (max, 1,5 g/day) 15 (max, 1 g/day) 30-40 (max, 2,4 g/day) 50b (max. 1,5 g/day) 40c (max, 1,6 g/day) 200 (max, 8 g/day) 40-60 (max, 8 g/day) 10 (max, 400 mg/day) 20 (max, 1,2 g/day) 2 (max, 100 mg/day) |
6/6 h p.o. 12/12 h p.o. 12/12 h p.o. 12/12 h p.o. 6/6 h or 8/8 h i.v. 8/8 h or 12/12 h p.o. 12/12 h p.o. 6/6 h i.v. 6/6 h i.v. 24/24 h i.v. or i.m. 12/12 h p.o. or i.v. 12/12 h i.v. |
| Haemophilus influenzae | Amoxicillin + Clavulanic acid Cefuroxime Cefaclor |
50b (max, 1,5 g/day) 20-30 (max, 1,5 g/day) 40 (max, 1 g/day) |
8/8 h or 12/12 h p.o. 12/12 h p.o. 8/8 h p.o. |
| Pseudomonas aeruginosa | Ciprofloxacin Amikacin Tobramycin Ceftazidime Cefepimee Piperacillin + tazobactame Meropeneme Aztreonam |
30-50 (max, 1,5 g/day) 30 (max, 1,2 g/day) 20-30 (max, 1,5 g/day) 10 (max, 660 mg/day) 150 (max, 9 g/day) 150 (max, 6 g/day) 300 (max, 18 g/day) 120 (max, 6 g/day) 50 (max, 6 g/day) |
12/12 h p.o. 8/8 h i.v. 24/24 h i.v. 24/24 h i.v. 8/8 h i.v. 8/8 h i.v. 6/6 h or 8/8 h i.v. 8/8 h i.v. 8/8 h i.v. |
| Stenotrophomonas maltophilia f | Sulfamethoxazole/trimethoprim Chloramphenicol Levofloxacin |
40c (max, 1,6g/day) 60 a 80 (max, 4 g/day) 10 (max, 750 mg/day) |
12/12 h p.o. 6/6 h p.o. or i.v. < 5 years o f age: 12/12 h > 5 years of age: 24/24 h |
| Burkholderia cepacia complexf.g | Sulfamethoxazole/trimethoprim Meropenem Chloramphenicol Doxycycline |
40c (max, 1,6 g/day) 100c (max, 2,4 g/day) 120 (max, 6 g/day) 60 a 80 (max, 4 g/day) 1-2 (max, 200 mg/day) |
12/12 h p.o. 6/6 h i.v. (severe cases) 8/8 h i.v. 6/6 h p.o. or i.v. 12/12 h p.o. |
Max: maximum. aIt is recommended to control the serum level of drugs whose laboratory tests are available (e.g.: aminoglycosides and vancomycin).bAmoxicillin dose. cSulfamethoxazole dose. dThey should only be used against methicillin-resistant Staphylococcus aureus. eAlso effective against methicillin-susceptible S. aureus. fLack of standardization regarding the level of efficacy of the antimicrobial agents. gUsually resistant to many antimicrobial agents.