Successful decolonization of methicillin-resistant Staphylococcus aureus in paediatric patients with cystic fibrosis (CF) using a three-step protocol

J Hosp Infect. 2007 Mar;65(3):231-6. doi: 10.1016/j.jhin.2006.10.011. Epub 2006 Dec 18.


Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a bacterial pathogen in patients with cystic fibrosis (CF) although its clinical effects can be variable. The aim of this study was to evaluate the efficacy of a three-step decolonization protocol for MRSA (Belfast CF MRSA decolonization protocol). Of the 17 paediatric patients treated during the five years of the study, eight (47%) were successfully decolonized following one five-day course of oral rifampicin and fusidic acid. The success rate increased to 12 (71%) patients after a second five-day oral treatment course in the 11 patients who remained culture positive at the end of the first treatment cycle. In a further four patients, clearance was achieved with a course of intravenous teicoplanin, increasing the decolonization rate to 16 of 17 patients (94%). These results compare favourably with other published studies and show that MRSA decolonization can be successful in a high proportion of paediatric CF patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / microbiology*
  • Drug Therapy, Combination
  • Female
  • Fusidic Acid / therapeutic use
  • Humans
  • Infant
  • Male
  • Methicillin Resistance / drug effects*
  • Pneumonia / drug therapy*
  • Rifampin / therapeutic use
  • Severity of Illness Index
  • Sputum / microbiology*
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / prevention & control
  • Staphylococcus aureus / drug effects*
  • Teicoplanin / therapeutic use


  • Anti-Bacterial Agents
  • Fusidic Acid
  • Teicoplanin
  • Rifampin