H Hall1, R Gadhok1, K Alshafi2, D Bilton3, N J Simmonds4. 1. Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. 2. Dept of Microbiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. 3. Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK. 4. Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK. Electronic address: n.simmonds@imperial.ac.uk.
Abstract
INTRODUCTION: The prevalence of MRSA in patients with CF is increasing. There is no consensus as to the optimum treatment. METHOD: An observational cohort study of all patients with MRSA positive sputum, 2007-2012. All eradication attempts with subsequent culture results were reviewed. Single vs dual antibiotic regimens were compared for both new and chronic infections. RESULTS: 37 patients (median FEV1 58.7 (27.6-111.5)% predicted) were identified, of which 67.6% (n = 25) had newly acquired MRSA. Compared with single regimens, a high proportion of dual regimens achieved MRSA eradication (84.6% vs 50%; p = 0.1) for new infections. Rifampicin/Fusidic acid was associated with high success rates (100% vs 60% for other dual regimens (p = 0.13)). Compared with new infections, chronic MRSA was much less likely to be eradicated (18.2%, p = 0.01). CONCLUSION: Combined antibiotic therapy, particularly Rifampicin/Fusidic acid, is a well-tolerated and effective means of eradicating MRSA in patients with cystic fibrosis.
INTRODUCTION: The prevalence of MRSA in patients with CF is increasing. There is no consensus as to the optimum treatment. METHOD: An observational cohort study of all patients with MRSA positive sputum, 2007-2012. All eradication attempts with subsequent culture results were reviewed. Single vs dual antibiotic regimens were compared for both new and chronic infections. RESULTS: 37 patients (median FEV1 58.7 (27.6-111.5)% predicted) were identified, of which 67.6% (n = 25) had newly acquired MRSA. Compared with single regimens, a high proportion of dual regimens achieved MRSA eradication (84.6% vs 50%; p = 0.1) for new infections. Rifampicin/Fusidic acid was associated with high success rates (100% vs 60% for other dual regimens (p = 0.13)). Compared with new infections, chronic MRSA was much less likely to be eradicated (18.2%, p = 0.01). CONCLUSION: Combined antibiotic therapy, particularly Rifampicin/Fusidic acid, is a well-tolerated and effective means of eradicating MRSA in patients with cystic fibrosis.
Authors: Emilie Vallières; Jacqueline C Rendall; John E Moore; John McCaughan; Anne I Hoeritzauer; Michael M Tunney; Joseph Stuart Elborn; Damian G Downey Journal: ERJ Open Res Date: 2016-03-15
Authors: Rodrigo Abensur Athanazio; Luiz Vicente Ribeiro Ferreira da Silva Filho; Alberto Andrade Vergara; Antônio Fernando Ribeiro; Carlos Antônio Riedi; Elenara da Fonseca Andrade Procianoy; Fabíola Villac Adde; Francisco José Caldeira Reis; José Dirceu Ribeiro; Lídia Alice Torres; Marcelo Bicalho de Fuccio; Matias Epifanio; Mônica de Cássia Firmida; Neiva Damaceno; Norberto Ludwig-Neto; Paulo José Cauduro Maróstica; Samia Zahi Rached; Suzana Fonseca de Oliveira Melo Journal: J Bras Pneumol Date: 2017 May-Jun Impact factor: 2.624