Oral antibiotics for children with Cystic Fibrosis

Background

Oral antibiotics may be used in CF for:

Prophylaxis against Staphylococcus aureus colonisation
Additional (“second-line”) treatment for increased respiratory symptom eg cough. The antibiotic of choice will be determined by current respiratory microbiology.
Eradication – See individual Guidelines

ORAL ANTIBIOTICS - PROPHYLAXIS – STAPHYLOCOCCUS AUREUS COLONISATION

ANTIBIOTIC

DOSE

NOTES

FLUCLOXACILLIN

From Birth
<5kg 62.5 mg bd
5- 10kg 125 mg bd
10-20 kg 250 mg bd
20 - 40kg 500mg bd
> 40kg 1g bd

Consider stopping at age 6 yrs if S aureus not cultured within last 12 months.

AZITHROMYCIN ²

PENICILLIN
ALLERGY

<15kg: 10mg/kg MON/WED/FRI

15-40 kg: 250mg MON/WED/FRI

>40kg: 500mg MON/WED/FRI

ORAL ANTIBIOTICS - ADDITIONAL (“SECOND-LINE”) ORAL ANTIBIOTIC TO TREAT NEW COUGH

Notes on Viral Colds

In keeping with current advice ^1,if patients have coryzal symptoms only without cough, no additional antibiotics are required.

If cough develops, patients should start their additional “second-line” antibiotics.

References

Doring G et al. Treatment of lung infection in patients with cystic fibrosis: current and future strategies. J Cyst Fibros. 2012 Dec;11(6):461-79. doi: 10.1016/j.jcf.2012.10.004. Epub 2012 Nov 6
Chmiel JF, Konstan MW, Elborn JS. Antibiotic and anti-inflammatory therapies for cystic fibrosis. Cold Spring Harb Perspect Med. ;3(10):a009779. Published . doi:10.1101/cshperspect.a009779 2013
CF Trust Antibiotic Treatment for Cystic Fibrosis 2009
Brompton Paediatric CF Guidelines 2017 [* Revised prophylactic Azithromycin dose 2019 for inclusion in 2020 version]
Scottish Paediatric Cystic Fibrosis Managed Clinical Network Prescribing Guidelines 2015

Editorial Information

Last reviewed: 25 May 2022

Next review: 25 May 2023

Author(s): Louise Thomson, Anne Devenny

Version: 2

Approved By: Paediatric Drugs & Therapeutics Committee

Document Id: 704