TABLE 2

Common antibiotics used for treatment of a pulmonary exacerbation in people with CF

Medication/class	Route of administration	Target pathogen	Observations/considerations	Use in pregnancy	Use in lactation
Tobramycin Aztreonam Levofloxacin Colistimethate	Inhaled	Pseudomonas aeruginosa	Little to no systemic absorption with inhaled route	Yes	Yes
Fluoroquinolones	Oral or i.v.	Pseudomonas aeruginosa	Low risk of fetal cartilage damage and generally avoided during pregnancy	Avoid	Yes
Aminoglycosides	i.v.	Pseudomonas aeruginosa	Generally avoided and used if severe infection or critically ill given eight cranial nerve toxicity with some aminoglycosides	Avoid	Yes
Piperacillin/tazobactam	i.v.	Pseudomonas aeruginosa	Considered low risk in pregnancy and lactation	Yes	Yes
Cephalosporins	i.v.	Pseudomonas aeruginosa/MSSA	Considered low risk in pregnancy and lactation	Yes	Yes
Carbapenems	i.v.	Pseudomonas aeruginosa/MSSA	CF women have been shown to be more likely to develop severe pre-eclampsia, and carbapenems lower the seizure threshold	Yes	Yes
Penicillins	Oral or i.v.	MSSA	Considered low risk in pregnancy and lactation	Yes	Yes
Trimethoprim-sulfamethoxazole	Oral or i.v.	MRSA	Trimethoprim may impair folic acid metabolism; sulfamethoxazole has been associated with fetal haemolytic anaemia and neonatal hyperbilirubinaemia	Avoid	Yes
Vancomycin	i.v.	MRSA	Limited human data during first trimester but no evidence of teratogenesis	Yes	Yes
Linezolid	Oral or i.v.	MRSA	Infants exposed during lactation should be monitored for diarrhoea or vomiting	Yes	Yes