Chronic Medications for Maintenance of Lung Health

Publication Date: January 3, 2013
Last Updated: March 14, 2022

RECOMMENDATIONS

UNCHANGED FROM 2007

Inhaled tobramycin—moderate to severe disease

For individuals with CF 6 years of age and older, with moderate to severe lung disease and Pseudomonas aeruginosa persistently present in cultures of the airways, the CF Foundation strongly recommends the chronic use of inhaled tobramycin to improve lung function and quality of life, and reduce exacerbations. (A)
322325

Inhaled tobramycin—mild disease

For individuals with CF 6 years of age and older, with mild lung disease and P. aeruginosa persistently present in cultures of the airways, the CF Foundation recommends the chronic use of inhaled tobramycin to reduce exacerbations. (B)
322325

Dornase alfa—moderate to severe disease

For individuals with CF 6 years of age and older, with moderate to severe lung disease, the CF Foundation strongly recommends the chronic use of dornase alfa to improve lung function, improve the quality of life, and reduce exacerbations. (A)
322325

Dornase alfa—mild disease

For individuals with CF 6 years of age and older, with asymptomatic or mild lung disease, the CF Foundation recommends the chronic use of dornase alfa to improve lung function and reduce exacerbations. (B)
322325

Inhaled hypertonic saline

For individuals with CF 6 years of age and older, the CF Foundation recommends the chronic use of inhaled hypertonic saline to improve lung function and quality of life and reduce exacerbations. (B)
322325

Azithromycin with P. aeruginosa

For individuals with CF 6 years of age and older, with P. aeruginosa persistently present in cultures of the airways, the CF Foundation recommends the chronic use of azithromycin to improve lung function and reduce exacerbations. (B)
322325

Oral antistaphylococcal antibiotics, prophylactic use

For individuals with CF, the CF Foundation recommends against the prophylactic use of oral antistaphylococcal antibiotics to improve lung function and quality of life or reduce exacerbations. (D)
322325

Inhaled corticosteroids

For individuals with CF 6 years of age and older, without asthma or allergic bronchopulmonary aspergillosis, the CF Foundation recommends against the routine use of inhaled corticosteroids to improve lung function or quality of life and reduce pulmonary exacerbations. (D)
322325

Oral corticosteroids

For individuals with CF 6 years of age and older, without asthma or allergic bronchopulmonary aspergillosis, the CF Foundation recommends against the chronic use of oral corticosteroids to improve lung function, quality of life or reduce exacerbations. (D)
322325

Other inhaled antibiotics

For individuals with CF 6 years of age and older, with P. aeruginosa persistently present in cultures of the airways, the CF Foundation concludes that the evidence is insufficient to recommend for or against the chronic use of other inhaled antibiotics (i.e., carbenicillin, ceftazidime, colistin, gentamicin) to improve lung function and quality of life or reduce exacerbations. (I)
322325

Oral antipseudomonal antibiotics

For individuals with CF 6 years of age and older, with P. aeruginosa persistently present in cultures of the airways, the CF Foundation concludes that the evidence is insufficient to recommend for or against the routine use of chronic oral antipseudomonal antibiotics to improve lung function and quality of life or reduce exacerbations. (I)
322325

Leukotriene modifiers

For individuals with CF 6 years of age and older, the CF Foundation concludes that the evidence is insufficient to recommend for or against the routine chronic use of leukotriene modifiers to improve lung function and quality of life or reduce exacerbations. (I)
322325

Inhaled or oral N-acetylcysteine, or inhaled glutathione

For individuals with CF 6 years of age and older, the CF Foundation concludes that the evidence is insufficient to recommend for or against the chronic use of inhaled or oral N-acetylcysteine or inhaled glutathione to improve lung function and quality of life or reduce exacerbations. (I)
322325

Inhaled anticholinergics

For individuals with CF 6 years of age and older, the CF Foundation concludes that the evidence is insufficient to recommend for or against the chronic use of inhaled anticholinergic bronchodilators to improve lung function and quality of life or reduce exacerbations (I)
322325
Severity of lung disease is defined by FEV1% predicted as follows: normal, >90% predicted; mildly impaired, 70–89% predicted; moderately impaired, 40–69% predicted; and severely impaired, <40% predicted.

Overview

Title

Chronic Medications for Maintenance of Lung Health

Authoring Organization

Cystic Fibrosis Foundation