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Evidence summaries

Prophylactic Anti-Staphylococcal Antibiotics for Cystic Fibrosis

Giving anti-staphylococcal antibiotic prophylaxis to young children with cystic fibrosis may lead to fewer children having isolates of Staphylococcus aureus but the clinical importance of this finding is uncertain. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 4 studies with a total of 401 subjects (aged zero to seven years on enrolment). Fewer children receiving anti-staphylococcal antibiotic prophylaxis had one or more isolates of Staphylococcus aureus. There was no significant difference between groups in infant or conventional lung function. No significant effect on nutrition, hospital admissions, additional courses of antibiotics or adverse effects were found. There was no significant difference in the number of isolates of Pseudomonas aeruginosa between groups, though there was a trend towards a lower cumulative isolation rate of Pseudomonas aeruginosa in the prophylaxis group at two and three years and towards a higher rate from four to six years. As the studies reviewed lasted six years or less, conclusions cannot be drawn about the long-term effects of prophylaxis.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding) and by indirectness (lack of data on important patient oriented outcomes).

References

  • Smyth A, Walters S. Prophylactic antibiotics for cystic fibrosis. Cochrane Database Syst Rev 2003;(3):CD001912 [Review content assessed as up-to-date: 20 November 2014] [PubMed]

Primary/Secondary Keywords