Utilization of antibiotics for methicillin‐resistant <i>Staphylococcus aureus</i> infection in cystic fibrosis

Zobell, Jeffery T.; Epps, Kevin; Young, David C.; Montague, Madison; Olson, Jared; Ampofo, Krow; Chin, Melissa J.; Marshall, Bruce C.; Dasenbrook, Elliott C.

doi:10.1002/ppul.23132

Cited by 41 publications

(66 citation statements)

References 19 publications

(44 reference statements)

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“…Dosing of vancomycin is based on the patient's weight and creatinine clearance. A trough concentration of 15 to 20 mg/ml, which is the practice of most CF physicians based on a recent survey (36), should be the considered target. Linezolid dosing may need adjustment in children with CF (37) but not adults (38).…”

Section: Methicillin-resistant Staphylococcus Aureusmentioning

confidence: 99%

Antibiotic Management of Lung Infections in Cystic Fibrosis. I. The Microbiome, Methicillin-Resistant Staphylococcus aureus, Gram-Negative Bacteria, and Multiple Infections

et al. 2014

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Despite significant advances in treatment strategies targeting the underlying defect in cystic fibrosis (CF), airway infection remains an important cause of lung disease. In this two-part series, we review recent evidence related to the complexity of CF airway infection, explore data suggesting the relevance of individual microbial species, and discuss current and future treatment options. In Part I, the evidence with respect to the spectrum of bacteria present in the CF airway, known as the lung microbiome is discussed. Subsequently, the current approach to treat methicillin-resistant Staphylococcus aureus, gram-negative bacteria, as well as multiple coinfections is reviewed. Newer molecular techniques have demonstrated that the airway microbiome consists of a large number of microbes, and the balance between microbes, rather than the mere presence of a single species, may be relevant for disease pathophysiology. A better understanding of this complex environment could help define optimal treatment regimens that target pathogens without affecting others. Although relevance of these organisms is unclear, the pathologic consequences of methicillin-resistant S. aureus infection in patients with CF have been recently determined. New strategies for eradication and treatment of both acute and chronic infections are discussed. Pseudomonas aeruginosa plays a prominent role in CF lung disease, but many other nonfermenting gram-negative bacteria are also found in the CF airway. Many new inhaled antibiotics specifically targeting P. aeruginosa have become available with the hope that they will improve the quality of life for patients. Part I concludes with a discussion of how best to treat patients with multiple coinfections.

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Section: Methicillin-resistant Staphylococcus Aureusmentioning

confidence: 99%

Antibiotic Management of Lung Infections in Cystic Fibrosis. I. The Microbiome, Methicillin-Resistant Staphylococcus aureus, Gram-Negative Bacteria, and Multiple Infections

et al. 2014

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“…3 In addition, a survey of CFF-accredited care centers in 2013 found that vancomycin and linezolid were the most commonly used antimicrobials for MRSA infections in children and adults. 4 Vancomycin is a glycopeptide antibiotic with a broad spectrum of activity against gram-positive organisms, including MRSA. Although vancomycin is frequently used for the management of acute pulmonary exacerbations in CF, optimal dosing has not been established in this population.…”

mentioning

confidence: 99%

Relationship between vancomycin dosage and serum trough vancomycin concentrations in pediatric patients with cystic fibrosis

Durham

Garza

Eiland

2016

American Journal of Health-System Pharmacy

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“…The evolution of resistance to LZD should be closely monitored among the MRSA clones circulating in Spain, as should the emergence of LZD resistance in patients with long-term treatments with this antibiotic. Although LZD is one of the most used antibiotics for MRSA infections in CF patients (28), its role should be revised due to its potential effect on the selection of resistant strains. …”

mentioning

confidence: 99%

Emergence of cfr -Mediated Linezolid Resistance in a Methicillin-Resistant Staphylococcus aureus Epidemic Clone Isolated from Patients with Cystic Fibrosis

Caballero

Pastor

Vindel

et al. 2016

Antimicrob Agents Chemother

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fResistance to linezolid (LZD) in methicillin-resistant Staphylococcus aureus (MRSA) isolates from patients with cystic fibrosis (CF) is due mainly to ribosomal mutations. We report on four CF patients with LZD-resistant MRSA bronchopulmonary infections by strains carrying the cfr gene. Strains from one patient also harbored the G2576U mutation (23S rRNA) and the G139R substitution (L3 protein). All strains belonged to the epidemic clone ST125 MRSA IVc. Our results support the monitoring of LZD resistance emergence in CF and non-CF MRSA isolates.

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Utilization of antibiotics for methicillin‐resistant Staphylococcus aureus infection in cystic fibrosis

Abstract: 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.

Cited by 41 publications

References 19 publications

Antibiotic Management of Lung Infections in Cystic Fibrosis. I. The Microbiome, Methicillin-Resistant Staphylococcus aureus, Gram-Negative Bacteria, and Multiple Infections

Antibiotic Management of Lung Infections in Cystic Fibrosis. I. The Microbiome, Methicillin-Resistant Staphylococcus aureus, Gram-Negative Bacteria, and Multiple Infections

Relationship between vancomycin dosage and serum trough vancomycin concentrations in pediatric patients with cystic fibrosis

Emergence of cfr -Mediated Linezolid Resistance in a Methicillin-Resistant Staphylococcus aureus Epidemic Clone Isolated from Patients with Cystic Fibrosis

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