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Antistaphylococcal (MSSA, MRSA, MSSE, MRSE) antibiotics
F Paradisi1, G Corti, D Messeri
1Clinic of Infectious Diseases, University of Florence School of Medicine, Florence, Italy. infdis@unifi.it
The Medical Clinics of North America
|February 24, 2001
Summary
Staphylococcal infections pose significant mortality and economic burdens. Emerging antimicrobial resistance necessitates exploring alternative treatments beyond standard beta-lactams and glycopeptides for challenging cases.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Staphylococcus aureus and coagulase-negative staphylococci cause severe infections, including bloodstream, cardiac, and device-related infections.
- Increasing antimicrobial resistance, particularly to beta-lactams and reduced susceptibility to glycopeptides, complicates treatment strategies.
- Staphylococcal infections contribute significantly to mortality and incur substantial economic costs.
Purpose of the Study:
- To review current treatment options for staphylococcal infections.
- To highlight the challenges posed by antimicrobial resistance in Staphylococcus species.
- To discuss the role of alternative and novel antimicrobial agents.
Main Methods:
- Literature review of antimicrobial resistance patterns in staphylococci.
- Analysis of treatment guidelines for staphylococcal infections.
- Evaluation of emerging and experimental antimicrobial drugs.
Main Results:
- Penicillin-susceptible strains require penicillin; penicillin-resistant strains are treated with oxacillin or nafcillin.
- Methicillin-resistant Staphylococcus aureus (MRSA) infections are primarily treated with glycopeptides.
- Alternative agents like co-trimoxazole, lincosamides, macrolides, tetracyclines, and fluoroquinolones are options for beta-lactam-allergic patients.
- Novel agents including streptogramins, oxazolidinones, carbapenems, everninomicins, and glycylcyclines show promise for multiresistant strains.
Conclusions:
- Effective management of staphylococcal infections hinges on appropriate antimicrobial selection based on susceptibility testing.
- The rise of antimicrobial resistance necessitates continuous evaluation and development of new therapeutic agents.
- Emerging drugs offer potential solutions for infections caused by multidrug-resistant staphylococci.