Off-label use of intravenous antimicrobials for inhalation in patients with cystic fibrosis

Pediatr Pulmonol. 2019 Nov:54 Suppl 3:S27-S45. doi: 10.1002/ppul.24511.

Abstract

Management of infections in patients with cystic fibrosis (CF) presents challenges for healthcare providers, including the eradication of initial acquisition, treatment of acute exacerbations, and chronic infection with suppressive therapy. Inhaled antimicrobial therapy for infections in patients with CF has been used in these capacities, often in an effort to achieve optimal concentrations in sputum for antimicrobial efficacy while mitigating potential toxicities associated with systemic therapy. Unfortunately, there are few commercially available products formulated for inhalation, resulting in the off-label use of other formulations, such as intravenous products, administered via nebulization. This review aims to examine the evidence supporting the efficacy of these off-label formulations for management of acute and chronic infections associated with CF, as well as adverse effects associated with their use.

Keywords: antimicrobials; cystic fibrosis.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / drug therapy*
  • Humans
  • Off-Label Use*
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / drug therapy*
  • Pseudomonas Infections / complications
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas aeruginosa*

Substances

  • Anti-Bacterial Agents