The pharmacokinetics of antibiotics in cystic fibrosis.

Expert Opinion on Drug Metabolism & Toxicology
Anne M Akkerman-NijlandDaniel J Touw

Abstract

Dosing of antibiotics in people with cystic fibrosis (CF) is challenging, due to altered pharmacokinetics, difficulty of lung tissue penetration, and increasing presence of antimicrobial resistance. The purpose of this work is to critically review original data as well as previous reviews and guidelines on pharmacokinetics of systemic and inhaled antibiotics in CF, with the aim to propose strategies for optimization of antibacterial therapy in both children and adults with CF. For systemic antibiotics, absorption is comparable in CF patients and non-CF controls. The volume of distribution (Vd) of most antibiotics is similar between people with CF with normal body composition and healthy individuals. However, there are a few exceptions, like cefotiam and tobramycin. Many antibiotic class-dependent changes in drug metabolism and excretion are reported, with an increased total body clearance for ß-lactam antibiotics, aminoglycosides, fluoroquinolones, and trimethoprim. We, therefore, recommend following class-specific guidelines for CF, mostly resulting in higher dosages per kg bodyweight in CF compared to non-CF controls. Higher local antibiotic concentrations in the airways can be obtained by inhalation therapy, with which eradi...Continue Reading

References

Nov 1, 1992·Antimicrobial Agents and Chemotherapy·B A ChristenssonB Strandvik
May 1, 1992·The Journal of Antimicrobial Chemotherapy·V BataillonP Roussel
Apr 1, 1991·Clinical Pharmacology and Therapeutics·R M HutabaratA L Smith
May 1, 1990·Clinical Pharmacology and Therapeutics·J MimeaultM LeBel
Jan 1, 1986·Infection·S W BenderH G Posselt
Mar 1, 1986·Journal of Clinical Pharmacology·J GoldfarbA V Mascia
Oct 1, 1988·The Journal of Antimicrobial Chemotherapy·R RamphalP Roussel
Aug 1, 1986·Antimicrobial Agents and Chemotherapy·M LeBelG Rivard
Jul 1, 1987·Infection·B GrenierR Thompson
Aug 1, 1988·Journal of Clinical Pharmacology·M D ReedJ L Blumer
Jun 1, 1987·Antimicrobial Agents and Chemotherapy·R L DavisA L Smith
Jan 1, 1986·European Journal of Clinical Pharmacology·E AutretB Grenier
Aug 1, 1985·Journal of Applied Physiology·G C Smaldone, M S Messina
Sep 1, 1984·Clinical Pharmacology and Therapeutics·J S LeederS M MacLeod
Nov 1, 1984·The Journal of Pediatrics·M SpinoS M MacLeod
Feb 1, 1982·The Journal of Pediatrics·G L KearnsJ T Wilson
Feb 1, 1982·The Journal of Pediatrics·H B KellyS Murphy
Jan 1, 1995·Antimicrobial Agents and Chemotherapy·B E HuntA L Smith
Dec 1, 1994·The European Respiratory Journal·H L ChuaP N Le Souef
Jul 1, 1993·Antimicrobial Agents and Chemotherapy·C E HulsJ A Bosso
Jan 1, 1996·Antimicrobial Agents and Chemotherapy·H G SchaeferU B Schaad
Jan 1, 1996·Antimicrobial Agents and Chemotherapy·R A PleasantsM R Knowles
Nov 13, 1998·Clinical Pharmacokinetics·E ReyG Pons
Dec 22, 1999·Therapeutic Drug Monitoring·P P Le BrunH G Heijerman
Dec 6, 2000·The European Respiratory Journal·G DöringD J Touw
Aug 3, 2001·Pediatrics in Review·P B Davis
May 10, 2002·Pediatric Pulmonology·C SchaedelL Holmberg
May 16, 2002·Pharmacotherapy·Michael J AsmusRichard C Ahrens
Feb 28, 2003·Lancet·Felix Ratjen, Gerd Döring
Nov 18, 2003·British Journal of Clinical Pharmacology·N R Labiris, M B Dolovich
Nov 24, 2005·Antimicrobial Agents and Chemotherapy·Paul BeringerMark Gill

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Citations

May 1, 2021·Antibiotics·Rosa María Girón MorenoRosa Mar Gómez-Punter
Sep 5, 2021·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·L H CameronF Ruiz

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