CF Guidelines - I.V. Antibiotics

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CF Guidelines - I.V. Antibiotics

Notes:
	Paediatric dose (if dose is also age dependent, then quoted as accordingly e.g. P < 5 = children younger than 5yrs; P5 - 16 = children aged between 5 and 16). Maximum adult dose used by other CF centres is given – for adults of small build, lower doses may be appropriate, calculate paediatric weight based dose for reference. Regimes used by CF centre may exceed maximum recommended BNF dose.

	od = once daily; bd = twice daily; tds = three times daily; qds = 4 times daily

Delivery:
	Bolus (B) – given over 5 mins / syringe. Fluid for reconstitution in vial given. Infusion (I) – typically given over 30 mins. All volumes are for adult doses. Generally reconstitute according to bolus then make up to final volume. The pharmacokinetics of bacterial killing by b-lactam antibiotics, cephalosporins and carbapenems means that slow infusions (eg delivered over 3hrs) have greater efficacy than 30 minute infusions. This difference may be clinically relevant when treating resistant pathogens or when patient tolerance limits the antibiotic dose which may be used.

Indications:
	Are not an exhaustative list of spectrum of activity:
	-	Burkholderia - Burkholderia cepacia complex (all genomovars).
	-	Ps.A - Pseudomonas aeruginosa.
	-	MR.PsA - Multi-resistant Pseudomonas aeruginosa refers more to clinical responsiveness of bacteria than to invitro resistance.

Comments:
	Where side effects (SE) are included, they complement those listed in the BNF.


	Anti-fungals such as Amphotericin, Caspofungin, Flucytosine (with Amphotericin), Posaconazole and Voriconazole may all be needed in CF patients. They are not included in the tables of IV antibiotics or oral antimicrobials as there are no CF specific dose modifications or side effects. Local microbiology advice should be sought before use.

	Dowloadable PDF File - PDF File
			Document approved - December 2011
			Document due for review - December 2013

	Acknowledgements: The Peninsula CF team acknowledges the use of guidelines produced by The CF Trust, Manchester, Papworth, Leeds and Brompton CF teams during development of these local Peninsula protocols and guidelines.

Disclaimer: While efforts have been made to ensure that all the information published on this web site is correct, the authors take no responsibility for the accuracy of information, or for harm arising as a consequence of errors contained within this web site. If you have concerns regarding treatment, drugs or doses then consult your local CF consultant.