Utilization of antibiotics for methicillin‐resistant Staphylococcus aureus infection in cystic fibrosis. Issue 6 (5th January 2015)

• Record Type: Journal Article
• Authors: Zobell, Jeffery T.; Epps, Kevin L.; Young, David C.; Montague, Madison; Olson, Jared; Ampofo, Krow; Chin, Melissa J.; Marshall, Bruce C.; Dasenbrook, Elliott
• Is Part Of: Pediatric pulmonology. Volume 50:Issue 6(2015:Jun.)
• Page Start: 552
• Page End: 559
• Publication Date: 2015-01-05
• Subjects: Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.23132
• Languages: English
• ISSNs: 8755-6863

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Summary</title> <sec id="ppul23132-sec-0001" sec-type="section"> <title>Objectives</title> <p>The purpose of this study was to characterize the utilization of antibiotics for chronic methicillin‐resistant <italic>Staphylococcus aureus</italic> (MRSA) infection in cystic fibrosis (CF) patients with acute pulmonary exacerbations (PEx).</p> </sec> <sec id="ppul23132-sec-0002" sec-type="section"> <title>Methods</title> <p>An anonymous national cross‐sectional survey of CF Foundation accredited care programs was performed using an electronic survey tool.</p> </sec> <sec id="ppul23132-sec-0003" sec-type="section"> <title>Results</title> <p>Fifty‐eight percent (152/261) CF Foundation accredited programs completed the survey. Ninety‐eight percent (149/152) of respondents reported using antibiotics (oral or intravenous) against MRSA. Variability exists in the use of antibiotics amongst the programs and in the dosages utilized. For oral outpatient treatment, sulfamethoxazole/trimethoprim was the most commonly utilized antibiotic by both pediatric (109/287, 38%) and adult (99/295, 34%) respondents, of which, ten percent of reported to use it in combination with rifampin. For inpatient treatment, linezolid (both intravenous (IV) and oral) was most commonly utilized in both pediatric (IV 35/224, 16%; oral 41/224, 18%), and adult (IV 44/235, 19%; oral 38/235, 16%) respondents for inpatient treatment. IV vancomycin was the second most commonly utilized antibiotic by pediatric (70/224, 31%) and adult (71/235, 30%) respondents. Most respondents reported dose titration to achieve a vancomycin trough level of 15–20 mg/L (150/179, 84%). Topical or inhaled antibiotic utilization was reported to be an uncommon practice with approximately 70% of pediatric and adult respondents reporting to use them either rarely or never. The concomitant use of anti‐MRSA and anti‐pseudomonal antibiotics was common with 96% of pediatric and 99% of adult respondents answering in the affirmative.</p> </sec> <sec id="ppul23132-sec-0004" sec-type="section"> <title>Conclusion</title> <p>We conclude that anti‐MRSA antibiotics are utilized via various dosage regimens by a majority of CF Foundation accredited care programs for the treatment of chronic MRSA in PEx, and there is no consensus on the best treatment approach. <bold>Pediatr Pulmonol. 2015; 50:552–559.</bold> © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>