Inhaled antibiotic benefit in cystic fibrosis wanes with CFTR modulators

An analysis of US CF Foundation Patient Registry data from 2011-2019 examined associations between chronic inhaled antibiotic prescriptions and lung function outcomes in people with cystic fibrosis, stratified by Pseudomonas aeruginosa infection status. The study reported that inhaled antibiotics were associated with increased risk of Aspergillus, Stenotrophomonas maltophilia, and Achromobacter infections, with the highest infection risk seen in Pa-negative patients who also showed no associated lung function benefit; among Pa-chronic patients, the antibiotic-associated lung function benefit was reported to decrease across successive eras of CFTR-modulator use (ivacaftor, lumacaftor/ivacaftor, tezacaftor/ivacaftor).

Most relevant for: People with cystic fibrosis being considered for or maintained on chronic inhaled antibiotic therapy, particularly those without chronic Pseudomonas aeruginosa infection or those using CFTR-modulator therapy.

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