PMID: 18611815Jun 1, 1997Paper

Antibiotics for treatment of infections caused by MRSA and elimination of MRSA carriage. What are the choices?

International Journal of Antimicrobial Agents
F J Schmitz, M E Jones

Abstract

The widespread appearance of methicillin resistant Staphylococcus aureus (MRSA) has significantly undermined the efficacy of currently available antibiotic therapies as strains tend to be multi-resistant. Clinicians are therefore faced with a restricted choice in effective anti-MRSA therapies for infection or elimination of carriage. MRSA remain uniformly susceptible to glycopeptides vancomycin and teicoplanin which remain drugs of choice in treatment of infections. Centres with a high incidence of MRSA should use glycopeptides as empirical monotherapies against these organisms. The low toxicity of teicoplanin makes it an alternative for patients unable to tolerate vancomycin. Only mupirocin is truly effective for use as a topical agent in elimination of MRSA colonisation. For systemic use developmental glycopeptides such as daptomycin, MDL 63246, and LY191145 show better in vitro activity than vancomycin. New cephalosporins TOC-39 and FK-037 show promising anti-MRSA potential with low MICs, as does carbapenem BO-2727 which has a high in vitro activity. Whether the new cephalosporins and carbapenems with good in vitro and/or in vivo activities against MRSA will be clinically effective remains to be determined. New fluoroquinolo...Continue Reading

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Related Concepts

Antibiotics
Carbapenems
Combined Modality Therapy
Drug Resistance
Glycopeptides
Problem
Rifampin
Trimethoprim-Sulfamethoxazole Combination
Vancomycin
Sparfloxacin

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