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.

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 (SA) and Pseudomonas aeruginosa (PA). Chronic infection of PA and methicillin-resistant S. aureus (MRSA) are associated with worse survival and antibiotic eradication treatment is recommended for both. This study compared the outcomes between intravenous (IV) and non-IV antibiotics in eradication of PA and MRSA. Methods: This was a single-center retrospective study. All respiratory specimen cultures of 309 CF patients and eradication regimens between 2015 and 2019 were reviewed. Patients received eradication treatment in case of first ever isolation or new isolation after being infection-free ≥1 year. 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: One hundred and two patients with PA isolations and 48 patients with MRSA were analyzed. At 1 year, 21.6% in PA group and 35.4% in MRSA group were successfully eradicated. There was not any statistically significant difference between IV versus non-IV antibiotic regimens on eradication in either group. Additionally, none of the clinical risk factors was significantly associated with eradication failure in PA and MRSA groups. Conclusion:In the eradication of PA and MRSA, IV and non-IV treatment regimens did not show any superiority to one another. Non-parenteral eradication could be a better option considering the cost-effectiveness and the treatment burden of IV treatments due to hospitalization and the need for IV access.

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Introduction and Objective: Microbiological surveillance guides the antibiotic therapy that plays an important role in maintaining the cystic fibrosis (CF) patients in stable clinical condition. Materials and Method: Respiratory samples (495 sputum, 711 deep pharyngeal swab) from 253 CF patients aged 0-43 were cultivated in conventional media and cumulative antibiogram was determined. A 24 questioned survey was applied to 119 patients for a 3 months period to measure demographic variabilities and knowledge about infection control. Results: The most common pathogen was Pseudomonas aeruginosa (45.7%), followed by Staphylococcus aureus (36%). P. aeruginosa was isolated from 60% of sputum samples and 28.5% of deep pharyngeal swab samples. High rate of resistance was detected to ceftazidime, amikacin and ciprofloxacin that are often preferred in treatment. Low monthly income, more than 9 visits to CF clinic in the last year, hospitalisation in the last year, spending more than 3 hours in CF clinic were significantly associated with P. aeruginosa colonisation. Health care providers was the main source of information (62.2% ).Vast majority of the patients (88.2%) knew that pathogens can be transmitted between the patients and infections could be reduced by using a mask, handwashing and by cleaning nebulizers as declared by 87.4% of participants clean the nebulizer after every usage and 93.3% of them dry it properly. Conclusion: Prevention of infections in CF patients is possible only if patients and their families are alert and have sufficient information about infection control that will provide great improvements in the prognosis.

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