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Comparison of Intravenous and Non-Intravenous Antibiotic Regimens in Eradication of P. aeruginosa and MRSA in Cystic Fibrosis
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  • Huseyin Hakan Mursaloglu ,
  • Can Akin,
  • Cansu Yılmaz Yegit,
  • Almala Ergenekon,
  • Burcu Uzunoglu,
  • Gamze Tastan ,
  • Yasemin Gokdemir,
  • Ela Erdem Eralp,
  • Aysegul Karahasan,
  • Fazilet Karakoc,
  • Bulent Karadag
Huseyin Hakan Mursaloglu
Marmara University Training and Research Hospital
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Can Akin
Marmara University School of Medicine
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Cansu Yılmaz Yegit
Marmara University
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Almala Ergenekon
Marmara University School of Medicine
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Burcu Uzunoglu
Marmara University School of Medicine
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Gamze Tastan
Marmara University School of Medicine
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Yasemin Gokdemir
Marmara University
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Ela Erdem Eralp
Marmara University Faculty of Medicine
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Aysegul Karahasan
Marmara University School of Medicine
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Fazilet Karakoc
Marmara University Faculty of Medicine
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Bulent Karadag
Marmara University Faculty of Medicine
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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 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.

Peer review status:IN REVISION

04 May 2021Submitted to Pediatric Pulmonology
05 May 2021Assigned to Editor
05 May 2021Submission Checks Completed
06 May 2021Reviewer(s) Assigned
27 May 2021Review(s) Completed, Editorial Evaluation Pending
28 May 2021Editorial Decision: Revise Major