State-of-the-Art Review: Transformative Changes in the Care of People With Cystic Fibrosis: Implications for Infectious Diseases Specialists

Transformative changes in care for people with cystic fibrosis (CF; pwCF) have occurred, including most recently, the widespread use of CF transmembrane regulator modulator therapy. These novel therapies improve lung function, decrease pulmonary exacerbations, increase life expectancy, and improve quality of life. Changes in the CF population have also occurred. There are now more adults than children living with CF. A growing proportion of pwCF are black and/or Hispanic, many of whom are ineligible for modulator therapy due to their CF transmembrane regulator mutations, which may further exacerbate disparities in healthcare. Management of pulmonary exacerbations-including shared decision making between pwCF and providers, the limitations of antimicrobial susceptibility testing to predict treatment response, and the role of antimicrobial stewardship-is increasingly recognized by the CF community. Collaborations among infectious diseases specialists, antimicrobial stewards, CF care teams, and clinical microbiology laboratories are increasingly needed to optimize these newer care paradigms.