Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) continues to be an important pathogen worldwide, with high prevalence of infection
in both community and hospital settings. Timely and appropriate choice of empirical
therapy in the setting of MRSA infection is imperative due to the high rate of associated
morbidity and mortality with MRSA infections. Initial choices should be made based
on the site and severity of the infection, most notably moderate skin and soft tissue
infections which may be treated with oral antibiotics (trimethoprim-sulfamethoxazole,
clindamycin, doxycycline/minocycline, linezolid) in the outpatient setting, versus
choice of parenteral therapy in the inpatient setting of more invasive or severe disease.
Though the current recommendations continue to strongly rely on vancomycin as a standard
empiric choice in the setting of severe/invasive infections, alternative therapies
exist with studies supporting their non-inferiority. This includes the use of linezolid
in pneumonia and severe skin and skin structure infections (SSSI) and daptomycin for
MRSA bacteremia, endocarditis, SSSIs and bone/joint infections. Additionally, concerns
continue to arise in regards to vancomycin, such as increasing isolate MICs, and relatively
high rates of clinical failures with vancomycin. Thus, the growing interest in vanomycin
alternatives, such as ceftaroline, ceftobribole, dalbavancin, oritavancin, and tedizolid,
and their potential role in treating MRSA infections.
Keywords
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Article info
Publication history
Published online: April 08, 2016
Accepted:
February 16,
2016
Received:
January 25,
2016
Identification
Copyright
© 2016 Published by Elsevier Ltd on behalf of Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.
