Common adverse effects of antibiotics used to treat NTM infections in patients with CF#
| Antibiotic (delivery route) | Common adverse effects | Suggested monitoring |
| Amikacin (intravenous; intramuscular)¶ | Nephrotoxicity Auditory-vestibular toxicity (tinnitus, high-frequency hearing loss) | Trough levels Serum creatinine |
| Amikacin (nebulisation)¶ | None described | |
| Azithromycin (oral)+ | Nausea, vomiting, diarrhoea Auditory-vestibular toxicity Prolonged QTc | Symptoms Audiology ECG |
| Bedaquiline (oral)¶ | Headaches, dizziness, joint aches Prolonged QTc Liver enzyme derangement | Symptoms ECG LFT |
| Cefoxitin (intravenous)¶ | Fever, rash Eosinophilia, anaemia, leukopenia, thrombocytopenia Interference with serum creatinine measurement | Symptoms FBC |
| Clofazimine (oral)¶ | Discoloration of skin or sclera Enteropathy (can mimic pancreatic insufficiency), nausea and vomiting | Symptoms |
| Ethambutol (oral)+ | Optic neuritis | Symptoms, colour vision and acuity |
| Imipenem (intravenous)¶ | Nausea, vomiting, diarrhoea Hepatitis | Symptoms LFT |
| Linezolid (oral)¶ | Anaemia, leukopenia, thrombocytopenia Peripheral neuropathy, optic neuritis | FBC Symptoms/clinical |
| Minocycline (oral)¶ | Photosensitivity, skin discolouration Nausea, vomiting, diarrhoea Vertigo | Symptoms |
| Moxifloxacin (oral)¶ | Nausea, vomiting, diarrhoea Insomnia, agitation, anxiety Tendonitis Photosensitivity Prolonged QTc | Symptoms ECG |
| Rifabutin (oral)+ | Leukopenia, anterior uveitis (when combined with clarithromycin), flu-like symptoms (polyarthralgia or myalgia) | Symptoms FBC |
| Rifampicin (oral)+ | Orange discolouration of bodily fluids, fever, chills, nausea, vomiting, diarrhoea Hepatitis Thrombocytopenia Renal failure Increased drug metabolism | Symptoms LFT FBC EUC |
| Streptomycin (intravenous, intramuscular)¶ | Nephrotoxicity | Trough levels, serum creatinine |
| Tigecycline (intravenous)¶ | Nausea, vomiting, diarrhoea Pancreatitis Hypoproteinaemia, bilirubinaemia | Symptoms Serum amylase, lipase LFT plus albumin |
LFT: liver function test; FBC: full blood count; EUC: electrolytes, urea and creatinine; QTc: corrected QT interval. #: based on United States CF Foundation (USCF) and European CF society (ECFS) consensus recommendations [46]; ¶: primarily used for Mycobacterium abscessus complex; +: primarily used for MAC. Reproduced from [10] with permission.