title: Interventions for the eradication of methicillin-resistant Staphylococcus aureus (MRSA) in people with cystic fibrosis.
abstract: BACKGROUND
  Cystic fibrosis is an inherited recessive disorder of chloride transport that is characterised by recurrent and persistent pulmonary infections from resistant organisms that result in lung function deterioration and early mortality in sufferers.Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as, not only an important infection in long-term hospitalised patients, but also as a potentially harmful pathogen in cystic fibrosis, and has been increasing steadily in prevalence internationally. Chronic pulmonary infection with MRSA is thought to confer cystic fibrosis patients with a worse overall clinical outcome and, in particular, result in an increased rate of decline in lung function. Clear guidance for the eradication of MRSA in cystic fibrosis, supported by robust evidence from good quality trials, is urgently needed.
  
  
  OBJECTIVE
  To evaluate the effectiveness of treatment regimens designed to eradicate MRSA and to determine whether the eradication of MRSA confers better clinical and microbiological outcomes for people with cystic fibrosis.
  
  
  METHODS
  Randomised and quasi-randomised controlled trials were identified by searching the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register, MEDLINE, EMBASE, handsearching article reference lists and through contact with local and international experts in the field.Date of the last search of the Group's Cystic Fibrosis Trials Register: 24 January 2013.
  
  
  METHODS
  Randomised or quasi-randomised controlled trials comparing any combinations of topical, inhaled, oral or intravenous antimicrobials with the primary aim of eradicating MRSA compared with placebo, standard treatment or no treatment.
  
  
  METHODS
  The authors independently assessed all search results for eligibility. No eligible trials were identified.
  
  
  RESULTS
  No current published eligible trials were identified, although two ongoing clinical trials are likely to be eligible for inclusion in future updates of this review.
  
  
  CONCLUSIONS
  We did not identify any randomised trials which would allow us to make any evidence-based recommendations. Although the results of several non-randomised studies would suggest that, once isolated, the eradication of MRSA is possible; whether this has a significant impact on clinical outcome is still unclear. Further research is required to guide clinical decision making in the management of MRSA infection in cystic fibrosis.
authors: Department of Child Health, School of Clinical Sciences & Nottingham Respiratory BRU, University of Nottingham, Nottingham,UK. david.lo@nottingham.ac.uk.
authors: David K H
authors: DK
authors: Lo
authors: Matthew N
authors: MN
authors: Hurley
authors: Marianne S
authors: MS
authors: Muhlebach
authors: Alan R
authors: AR
authors: Smyth
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000382:microbiology*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents