title: Eradication of respiratory tract MRSA at a large adult cystic fibrosis centre.
abstract: BACKGROUND
  The prevalence of MRSA in patients with CF is increasing. There is no consensus as to the optimum treatment.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Combined antibiotic therapy, particularly Rifampicin/Fusidic acid, is a well-tolerated and effective means of eradicating MRSA in patients with cystic fibrosis.
authors: Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
authors: H
authors: H
authors: Hall
authors: Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
authors: R
authors: R
authors: Gadhok
authors: Dept of Microbiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
authors: K
authors: K
authors: Alshafi
authors: 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.
authors: D
authors: D
authors: Bilton
authors: 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.
authors: N J
authors: NJ
authors: Simmonds
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003550:Cystic Fibrosis / Q000150:complications*; D060740:Disease Eradication; D004359:Drug Therapy, Combination; D005260:Female; D005672:Fusidic Acid / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy / Q000382:microbiology; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D005672:Fusidic Acid; D012293:Rifampin
keywords: Cystic fibrosis; Eradication; Infection; MRSA; Methicillin resistant Staphylococcus aureus