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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
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Treatment strategies for persistent methicillin-resistant Staphylococcus aureus bacteraemia
Paul O Lewis1, Emily L Heil2, Kelly L Covert3
1Department of Pharmacy, Johnson City Medical Center, Johnson City, Tennessee.
Journal of Clinical Pharmacy and Therapeutics
|July 14, 2018
Summary
Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia requires careful management. Review of case studies suggests various salvage therapies, but further trials are needed for optimal treatment strategies.
Area of Science:
- Infectious Diseases
- Antimicrobial Therapy
- Clinical Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia poses significant clinical challenges, including metastatic infections, treatment failure, and mortality.
- Current guidelines for persistent MRSA bacteraemia recommend source control and potential therapy modification.
Purpose of the Study:
- To review and explore therapeutic options for treating persistent MRSA bacteraemia.
- To identify potential salvage regimens for refractory cases.
Main Methods:
- A comprehensive literature search was conducted on PubMed, MEDLINE, and Google Scholar.
- Search terms included MRSA, bacteraemia, persistence, and treatment, focusing on adult, English-language studies from 1985 to May 2018.
- In vitro and animal studies were included to support in vivo findings.
Main Results:
- Randomized controlled trials are scarce for persistent MRSA bacteraemia.
- Case series and reports indicate multiple salvage options: high-dose daptomycin with beta-lactams, ceftaroline (alone or combined), trimethoprim-sulfamethoxazole (TMP-SMX), fosfomycin, linezolid, and telavancin.
Conclusions:
- No single preferred regimen has emerged due to data heterogeneity.
- Treatment decisions should consider patient history, source control, and available synergy data.
- Further comparative trials are essential to establish a preferred regimen and a universal treatment algorithm.
Keywords:
bacteraemiaceftarolinedaptomycinmethicillin-resistant Staphylococcus aureussalvage therapytelavancintreatment failurevancomycinMore Related Videos
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