Ann Pharmacother

Doxycycline comparable to vancomycin for MRSA pulmonary exacerbations in CF

January 13, 2025

Clinical impact: Findings of this study suggest that doxycycline may be a viable alternative to vancomycin for treating MRSA-associated acute pulmonary exacerbations (APEs) in cystic fibrosis (CF) patients, particularly for those who may not tolerate vancomycin or require concomitant nephrotoxic agents. This could provide more flexibility in managing these complex cases.

Study design: This multicenter retrospective cohort study included 89 patients with CF who received either doxycycline (n = 63) or vancomycin (n = 26) for >48 hours to treat MRSA-associated APEs. The primary outcome measured was return to ≥90% of baseline forced expiratory volume in the first second (FEV1).

Results: There wasn't a significant difference between the two groups in achieving the primary outcome: 81.0% in the doxycycline group vs. 69.2% in the vancomycin group (p = 0.23). Secondary outcomes, including time to clinical improvement and length of hospital stay, were also comparable between the two treatments. The incidence of acute kidney injury was similar between groups, although a significantly higher incidence of adverse events occurred in the vancomycin arm.

Source:

Brickel KH, et al. (2025, January 8). Ann Pharmacother. Doxycycline Versus Vancomycin for the Treatment of Methicillin-Resistant Staphylococcus Aureus-Associated Acute Pulmonary Exacerbations in People With Cystic Fibrosis. https://pubmed.ncbi.nlm.nih.gov/39780358/