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Treatment of Infection and Colonization Caused by Methicillin-Resistant Staphylococcus aureus

Published online by Cambridge University Press:  21 June 2016

Henry F. Chambers
Henry F. Chambers*
Affiliation:
The Medical Service, San Francisco General Hospital and The Department of Medicine, School of Medicine, University of California, San Francisco, California
*
The Medical Service, 5H22, San Francisco General Hospital, San Francisco, CA 94110
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Abstract

The mechanism of methicillin resistance confers resistance to all available B-lactam antibiotics; consequently, B-lactam antibiotics have no role in therapy of methicillin-resistant Staphylococcus aureus (MRSA) infections. Vancomycin remains the drug of choice. Teicoplanin and daptomycin are two investigational antibiotics related to vancomycin in structure and in spectrum of activity. In clinical trials employing relatively low doses, neither was as effective as vancomycin. Trials at higher doses are on-going. Quinolones, ciprofloxacin in particular, have been used successfully to treat infections caused by MRSA; however, the usefulness of quinolones may be limited by the tendency of resistance to emerge during therapy. Quinolones probably should be used only in combination with another active agent, such as rifampin, when treating serious infections caused by MRSA. Other agents may be active in vitro against MRSA, but clinical data showing their effectiveness are lacking. Rifampin combination regimens appear most effectively to eradicate colonization with MRSA.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 1 , January 1991 , pp. 29 - 35
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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