Abstract
Background: Chronic pulmonary infection is the leading cause of
mortality and morbidity in patients with cystic fibrosis (CF). The most
common pathogens isolated in CF are Staphylococcus aureus andPseudomonas aeruginosa (P. aeruginosa ). Chronic infection
of P. aeruginosa and MRSA are associated with worse survival and
antibiotic eradication treatment is recommended for both. This study
evaluates the efficacy of intravenous (IV) vs. non-IV antibiotics in the
eradication of P. aeruginosa and MRSA.
Methods: This was a single-center retrospective study at a
large CF center. All respiratory specimen cultures of 309 CF patients
and eradication regimens between 2015-2019 were reviewed. The primary
analysis was the comparison of the percentage of successful eradication
after receiving IV and non-IV eradication regimens. Demographic and
clinical risk factors for eradication failure were also analyzed.
Results: 102 patients with P. aeruginosa isolations and
48 patients with MRSA were analyzed. At one year, 21.6% in P.
aeruginosa group and 35.4% in MRSA group were successfully eradicated.
There was not any statistically significant difference between IV vs.
non-IV antibiotic regimens on eradication in either group. Additionally,
none of the clinical risk factors was significantly associated with
eradication failure in P. aeruginosa and MRSA groups.
Conclusion: In the eradication of P. aeruginosa and
MRSA, IV and non-IV treatment regimens did not show any superiority to
one another. Non-parenteral eradication could be a better option in
eradication considering the cost-effectiveness and the treatment burden
of IV treatments due to hospitalization and the need for IV access.
Keywords: Cystic fibrosis, Pseudomonas Aeruginosa, MRSA,
eradication, antibiotic, chronic infection