Management of Respiratory Exacerbations, in Cystic Fibrosis (Oxford Respiratory Medicine Library) (2010).

Horsley AR

Oxford University Press

• Early recognition and treatment of CF exacerbations is one of the cornerstones of modern CF care
• Diagnosis is essentially clinical, based largely on patient symptoms
• Anything other than very mild exacerbations requires intravenous antibiotics, typically for 10–21 days
• Choice of antibiotics should be based upon known antimicrobial sensitivities
• Monotherapy should be avoided in infections
• In patients colonized with , treatment usually involves a combination of a β-lactam antibiotic and an aminoglycoside
• Treatment can be delivered at home but requires the same assessment as for inpatients, and close monitoring
• Treatment is multidisciplinary and also involves attention to physiotherapy, nutrition and glucose homeostasis
• Antibiotic hypersensitivities are common, particularly in those with repeated courses of treatment
• Antibiotic desensitization can be attempted for each course if necessary