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Despite aggressive management with two or more intravenous anti\u2010pseudomonal agents, approximately 25% of exacerbations will result in a loss of lung function. The aim of this review is to provide an evidence\u2010based summary of pharmacokinetic\/pharmacodynamic (PK\/PD), tolerability, and efficacy studies utilizing anti\u2010pseudomonal cephalosporins (i.e., ceftazidime and cefepime) and penicillins (i.e., piperacillin\u2013tazobactam and ticarcillin\u2013clavulanate) in the treatment of APE and to identify areas where further study is warranted. The ceftazidime and cefepime dosing ranges from the literature are 200\u2013400\u2009mg\/kg\/day divided every 6\u20138\u2009hr, maximum 8\u201312\u2009g\/day, and 150\u2013200\u2009mg\/kg\/day divided every 6\u20138\u2009hr, up to 6\u20138\u2009g\/day, respectively. The literature supported dosing ranges for piperacillin and ticarcillin are 350\u2013600\u2009mg\/kg\/day divided every 4\u2009hr, maximum 18\u201324\u2009g\/day of piperacillin component, and 400\u2013750\u2009mg\/kg\/day divided every 6\u2009hr, up to 24\u201330\u2009g\/day of ticarcillin component, respectively. As a large portion of CF patients will not regain their lung function following an APE, we suggest the need to optimize antibiotic dosing and dosing regimens used to treat an APE in efforts to improve outcomes for CF patients infected with <jats:italic>Pseudomonas aeruginosa<\/jats:italic>. Future studies are needed to determine the clinical efficacy of higher than FDA\u2010approved doses of ceftazidime, cefepime, and ticarcillin\u2013clavulanate in APE. The usefulness of high dose piperacillin (&gt;600\u2009mg\/kg\/day) may be limited due to treatment\u2010related adverse effects. Further understanding of these adverse effects in CF patients is needed. Pediatr Pulmonol. 2013; 48:107\u2013122. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ppul.22669","type":"journal-article","created":{"date-parts":[[2012,9,4]],"date-time":"2012-09-04T13:08:15Z","timestamp":1346764095000},"page":"107-122","source":"Crossref","is-referenced-by-count":47,"title":["Optimization of anti\u2010pseudomonal antibiotics for cystic fibrosis pulmonary exacerbations: II. cephalosporins and penicillins"],"prefix":"10.1002","volume":"48","author":[{"given":"Jeffery T.","family":"Zobell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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