Table 2

Antibiotic-dosing regimens used to treat Mycobacterium avium complex and Mycobacterium abscessus complex pulmonary disease in cystic fibrosis

AntibioticRouteDose suitable for children/adolescentsDose suitable for adults
Amikacin*IntravenousChildren: 15–30 mg/kg/dose once daily
Adolescents: 10–15 mg/kg/dose once daily
Maximum dose 1500 mg daily
10–30 mg/kg once daily
or
15 mg/kg/day in two divided doses
Daily to 3× weekly dosing
Amikacin*†‡Nebulised250–500 mg/dose once or twice daily250–500 mg once or twice daily
AzithromycinOralChildren: 10–12 mg/kg/dose once daily
Adolescents: adult dosing regimen
Maximum dose 500 mg
250–500 mg once daily
CefoxitinIntravenous50 mg/kg/dose thrice daily (maximum dose 12 g/day)200 mg/kg/day in three divided doses (maximum dose 12 g/day)
ClarithromycinOral7.5 mg/kg/dose twice daily (maximum dose 500 mg)500 mg twice daily§
ClarithromycinIntravenousNot recommended500 mg twice daily§
Clofazimine†¶Oral1–2 mg/kg/dose once daily (maximum dose 100 mg)50–100 mg once a day
Co-trimoxazole (sulfamethoxazole and trimethoprim)Oral10–20 mg/kg/dose twice daily960 mg twice daily
Co-trimoxazole (sulfamethoxazole and Trimethoprim)Intravenous10–20 mg/kg/dose twice daily1.44 g twice daily
EthambutolOralInfants and children: 15 mg/kg/dose once daily
Adolescents: 15 mg/kg/dose once daily
15 mg/kg once daily
ImipenemIntravenous15–20 mg/kg/dose twice daily (maximum dose 1000 mg)1 g twice daily
Linezolid**Oral<12 years old: 10 mg/kg/dose thrice daily
12 years and older: 10 mg/kg/dose once or twice daily (maximum dose 600 mg)
600 mg once or twice daily
Linezolid**Intravenous<12 years old: 10 mg/kg/dose thrice daily
12 years and older: 10 mg/kg/dose once or twice daily (maximum dose 600 mg)
600 mg once or twice daily
MoxifloxacinOral7.5–10 mg/kg/dose once daily (maximum dose 400 mg daily)400 mg once daily
MinocyclineOral2 mg/kg/dose once daily (maximum dose 200 mg)100 mg twice daily
Rifampin (Rifampicin)Oral10–20 mg/kg/dose once daily (maximum dose 600 mg)<50 kg 450 mg once daily
>50 kg 600 mg once daily
RifabutinOral5–10 mg/kg/dose once daily (maximum dose 300 mg)150–300 mg once daily
150 mg if patient taking strong CYP3A4 inhibitor
450–600 mg if patient taking strong CYP3A4 inducer
Streptomycin*Intramuscular/intravenous20–40 mg/kg/dose once daily (maximum dose 1000 mg)15 mg/kg once daily (maximum dose 1000 mg)
Tigecycline†,††Intravenous8–11 years: 1.2 mg/kg/dose twice daily (maximum dose 50 mg)
12 years and older: 100 mg loading dose and then 50 mg once or twice daily
100 mg loading dose and then 50 mg once or twice daily
  • *Adjust dose according to levels. Usually, starting dose is 15 mg/kg aiming for a peak level of 20–30 µg/mL and trough levels of <5–10 micrograms/ml.

  • †As tolerated.

  • ‡Mixed with normal saline.

  • §For individuals under 55 kg, many practitioners recommend 7.5 mg/kg twice daily.

  • ¶Only available in the USA through an IND application to the FDA.

  • **Usually given with high dose (100 mg daily) pyridoxine (vitamin B6) to reduce risk of cytopaenias.

  • ††Many practitioners recommend pre-dosing with one or more anti-emetics before dosing and/or gradual dose escalation from 25 mg daily to minimise nausea and vomiting.

  • IND, investigational new drug; FDA, Food and Drug Administration.