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

Medication/classRoute of administrationTarget pathogenObservations/considerationsUse in pregnancyUse in lactation
InhaledPseudomonas aeruginosaLittle to no systemic absorption with inhaled routeYesYes
FluoroquinolonesOral or i.v.Pseudomonas aeruginosaLow risk of fetal cartilage damage and generally avoided during pregnancyAvoidYes
Aminoglycosidesi.v.Pseudomonas aeruginosaGenerally avoided and used if severe infection or critically ill given eight cranial nerve toxicity with some aminoglycosidesAvoidYes
Piperacillin/tazobactami.v.Pseudomonas aeruginosaConsidered low risk in pregnancy and lactationYesYes
Cephalosporinsi.v.Pseudomonas aeruginosa/MSSAConsidered low risk in pregnancy and lactationYesYes
Carbapenemsi.v.Pseudomonas aeruginosa/MSSACF women have been shown to be more likely to develop severe pre-eclampsia, and carbapenems lower the seizure thresholdYesYes
PenicillinsOral or i.v.MSSAConsidered low risk in pregnancy and lactationYesYes
Trimethoprim-sulfamethoxazoleOral or i.v.MRSATrimethoprim may impair folic acid metabolism;
sulfamethoxazole has been associated with fetal haemolytic anaemia and neonatal hyperbilirubinaemia
Vancomycini.v.MRSALimited human data during first trimester but no evidence of teratogenesisYesYes
LinezolidOral or i.v.MRSAInfants exposed during lactation should be monitored for diarrhoea or vomitingYesYes