Anti-inflammatory treatment for cystic fibrosis

The host inflammatory response plays a role in lung injury in cystic fibrosis (CF); anti-inflammatory treatments have been shown to be beneficial.

The macrolide antibiotic azithromycin (usually given orally three times a week) is used in CF for its anti-inflammatory properties. Azithromycin can improve lung function, reduce the rate of exacerbations and achieve weight gain.

The best evidence for the anti-inflammatory effect of azithromycin is for CF with Pseudomonas aeruginosa infection, but it may also be beneficial for CF with other chronic bacterial infections such as Staphylococcus aureus and Haemophilus influenzae.

Do not routinely prescribe an inhaled or oral corticosteroid in a patient with CF unless the patient has another indication for a corticosteroid (eg inhaled corticosteroid for asthma, oral corticosteroid for allergic bronchopulmonary aspergillosis [ABPA]).