Comparison of Intravenous and Non-Intravenous Antibiotic Regimens in
Eradication of P. aeruginosa and MRSA in Cystic Fibrosis
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 and
Pseudomonas 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.