Materiały źródłowe

• #1 MRSA: Causes, Symptoms, and Treatment

  https://patient.info/infections/mrsa-leaflet

  Infection with MRSA bacteria mainly occurs in people who are already ill in hospital. […] It can be difficult to treat MRSA, as the bacteria are resistant to most types of antibiotic medicines. […] Most S. aureus infections can be treated with commonly used antibiotics. However, MRSA infections are resistant to an antibiotic called meticillin and also to many other types of antibiotics. […] MRSA infections are usually only treated with antibiotics if they are causing a problem. […] However, the choice of antibiotic is limited, as most antibiotics will not work. […] Many MRSA infections can only be treated with antibiotics that need to be given directly into a vein. […] If you are found to be a carrier of MRSA then you are usually offered treatment which prevents future infections or the spread of MRSA. This is called decolonisation treatment. […] If you are found to be carrying MRSA before you go into hospital then you will be given treatment to destroy (eradicate) it as much as possible.

• #2 MRSA: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/10634

  MRSA is a common and potentially serious infection that has developed resistance to several types of antibiotics. These include methicillin and related antibiotics, such as penicillin, vancomycin, and oxacillin. This resistance makes MRSA difficult to treat. […] Although doctors can no longer use methicillin to treat MRSA, this does not mean that the infection is untreatable. Some antibiotics are effective in treating it. […] The type of treatment for MRSA will depend on the following factors: the type and location of the infection, the severity of the symptoms, the antibiotics to which the strain of MRSA responds. […] The bacteria that cause MRSA are resistant to some but not all antibiotics. A doctor will prescribe medication that is suitable for the particular infection that occurs. […] A person should make sure that they take the whole course of antibiotics exactly as the doctor prescribes. Some people stop taking the drugs after the symptoms disappear, but this can increase the risk of the infection coming back and becoming resistant to treatment.

• #3 Methicillin-Resistant Staphylococcus Aureus (MRSA) | BCM

  https://www.bcm.edu/departments/molecular-virology-and-microbiology/emerging-infections-and-biodefense/specific-agents/mrsa

  MRSA is categorized by the setting in which it is acquired. The first type, healthcare-acquired MRSA (HA-MRSA), has been recognized since the 1960s. […] Of greater concern is a second type of MRSA which appeared in the 1990s and is known as community-acquired MRSA (CA-MRSA). […] The best defense against MRSA is to maintain good hygiene, including frequent and thorough hand washing, and to avoid the sharing of personal care items. […] The rising problem of resistance of staph bacteria to methicillin and other antibiotics is part of a larger issue that greatly concerns healthcare professionals. […] The consequences of antimicrobial resistance pose a significant concern to scientists and medical professionals. […] This information can help doctors select the optimal antibiotic treatment for infected patients.

• #4 MRSA: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/10634

  MRSA is a common and potentially serious infection that has developed resistance to several types of antibiotics. These include methicillin and related antibiotics, such as penicillin, vancomycin, and oxacillin. This resistance makes MRSA difficult to treat. […] Although doctors can no longer use methicillin to treat MRSA, this does not mean that the infection is untreatable. Some antibiotics are effective in treating it. […] The type of treatment for MRSA will depend on the following factors: the type and location of the infection, the severity of the symptoms, the antibiotics to which the strain of MRSA responds. […] The bacteria that cause MRSA are resistant to some but not all antibiotics. A doctor will prescribe medication that is suitable for the particular infection that occurs. […] A person should make sure that they take the whole course of antibiotics exactly as the doctor prescribes. Some people stop taking the drugs after the symptoms disappear, but this can increase the risk of the infection coming back and becoming resistant to treatment.

• #5 MRSA: Causes, Symptoms, Diagnosis, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/11633-methicillin-resistant-staphylococcus-aureus-mrsa

  MRSA infections are hard to treat because very few antibiotics are effective against them. […] Providers treat MRSA infections by caring for open wounds and finding antibiotics that are effective against the strain of MRSA you have. Wound treatment includes draining fluid and surgically removing infected tissue. […] Antibiotics a provider might use to treat MRSA include: Vancomycin, Rifampin, Trimethoprim/sulfamethoxazole (TMP/SMX), Ceftaroline, Linezolid, Daptomycin, Clindamycin, Doxycycline, Delafloxacin. […] Sometimes, MRSA is called a superbug because its defense mechanisms against so many antibiotics make it hard to treat. One strategy providers might use is to treat you with more than one type of antibiotic at a time. […] If you have a skin infection, your provider will surgically treat and drain your wounds. They might give you topical or oral antibiotics. You’ll need to be treated in the hospital if you have a severe or invasive MRSA infection. […] Yes, more than half of all MRSA cases are cured with antibiotics, and providers successfully treat most MRSA skin infections. But serious infections like pneumonia, endocarditis and bacteremia can quickly get worse before a provider can find a treatment that works.

• #6 Methicillin-resistant Staphylococcus aureus (MRSA) Basics | MRSA | CDC

  https://www.cdc.gov/mrsa/about/index.html

  Healthcare providers often prescribe antibiotics to treat MRSA infections. […] Some types of S. aureus infections need surgery to drain infected areas. Your healthcare provider will determine which treatments are best for you. While MRSA can be resistant to several antibiotics, meaning these drugs cannot cure the infections, there are antibiotics available to treat MRSA infections.

• #7 MRSA Infection in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=mrsa-infection-in-children-160-49

  Your child will likely be treated with antibiotic medicine. […] If your child has a mild MRSA skin infection, the healthcare provider will likely treat it by opening the infected sore and draining out the fluid (pus). You will likely be given a prescription antibiotic ointment to use on your child. Your child may also need to take antibiotic medicine by mouth. […] Don’t try to treat a MRSA infection on your own. This can spread the infection to other people or make it worse for your child. Cover the infected area, wash your hands, and call your child’s healthcare provider.

• #8 Recommended Treatments for Community-Acquired MRSA Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0501/p802.html

  Community-acquired MRSA skin and soft-tissue infections, such as pustules, furuncles, and small abscesses, usually respond to incision and drainage. This may be sufficient to treat small, uncomplicated purulent lesions, although clear evidence is lacking. More complicated lesions (i.e., those with surrounding cellulitis or no drainable foci) are usually treated with antimicrobial agents. Patients with fever or other systemic symptoms are also usually treated with antimicrobial agents. […] Trimethoprim/sulfamethoxazole (TMP/SMX; Bactrim, Septra) is the agent most commonly used to treat adults with community-acquired MRSA infections in the United States. In vitro evidence suggests TMP/SMX has greater bactericidal activity against community-acquired MRSA than linezolid (Zyvox), rifampin (Rifadin), clindamycin (Cleocin), or minocycline (Minocin). A retrospective review showed TMP/SMX to be effective for skin and soft-tissue infections.

• #9 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics/print

  In addition to antibiotics, your health care provider may drain the infected area by inserting a needle or making a small cut in the skin. This is done to reduce the amount of infected material (pus), which will help the tissue to heal. […] […] In the hospital — Hospitalized people with MRSA infections are usually treated with an intravenous medication. The intravenous antibiotic is usually continued until the person is improving. […] […] In many cases, the person will be given antibiotics after discharge from the hospital, either by mouth or by intravenous (IV). This may be needed for a short period of time or for as long as six to eight weeks. Intravenous antibiotics can be given at home, by a visiting nurse, or in a rehabilitation facility. […] […] In the hospital, if you are colonized but not infected with MRSA, you may be treated with mupirocin ointment and chlorhexidine soap.

• #10 Learning about MRSA: A guide for Patients – MN Dept. of Health

  https://www.health.state.mn.us/diseases/staph/mrsa/book.html

  Don’t do this yourself. It is very dangerous to squeeze or poke a skin infection because it can push the bacteria deeper into the skin and make the infection much worse. Your doctor will open the sore and drain it. After the infection is drained, you must keep it covered with a clean, dry bandage, until it heals. […] To decrease the amount of staph on your body your doctor may, for a short period of time: Tell you to shower daily with antibacterial soap, Prescribe antibiotic ointment to put in your nose for several days, Prescribe antibiotic pills (in some cases). […] Contact your doctor if: you have any new symptoms during or after treatment for a MRSA skin infection such as a new fever or a fever that won’t go away, the infection gets worse, the infection is not healing, the infection comes back, you have questions.

• #11 Learning about MRSA: A guide for Patients – MN Dept. of Health

  https://www.health.state.mn.us/diseases/staph/mrsa/book.html

  Don’t do this yourself. It is very dangerous to squeeze or poke a skin infection because it can push the bacteria deeper into the skin and make the infection much worse. Your doctor will open the sore and drain it. After the infection is drained, you must keep it covered with a clean, dry bandage, until it heals. […] To decrease the amount of staph on your body your doctor may, for a short period of time: Tell you to shower daily with antibacterial soap, Prescribe antibiotic ointment to put in your nose for several days, Prescribe antibiotic pills (in some cases). […] Contact your doctor if: you have any new symptoms during or after treatment for a MRSA skin infection such as a new fever or a fever that won’t go away, the infection gets worse, the infection is not healing, the infection comes back, you have questions.

• #12 MRSA: Symptoms, Causes, Treatments, and Your Risk

  https://www.webmd.com/skin-problems-and-treatments/understanding-mrsa

  The treatment that you need depends on what kind of infection you have and where it is. For example, it may be limited to a skin infection, or the bacteria may have entered your bloodstream. […] Treatment may include: […] Draining fluid from an abscess […] Surgically removing tissue that’s infected […] Prescribing antibiotics that can treat MRSA. […] If you have only a skin infection, you might not need any antibiotics. But it’s important that you don’t try to drain the abscess yourself because you can make the infection worse. Be sure to get treatment from a health care provider. […] While MRSA skin infections can usually be treated in your doctor’s office, severe infections will land you in the hospital. You’ll get antibiotics through an IV to help kill the infection. […] Although strands of HA-MRSA and CA-MRSA come from the same bacterium, Staphylococcus aureus, they have different levels of resistance and virulence the ability to infect and cause disease. HA-MRSA is resistant to more types of antibiotics than CA-MRSA is.

• #13 Methicillin-resistant Staphylococcus aureus – Wikipedia

  https://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

  Linezolid, quinupristin/dalfopristin, daptomycin, ceftaroline, and tigecycline are used to treat more severe infections that do not respond to glycopeptides such as vancomycin. Current guidelines recommend daptomycin for VISA bloodstream infections and endocarditis. […] In skin abscesses, the primary treatment recommended is removal of dead tissue, incision, and drainage. More information is needed to determine the effectiveness of specific antibiotics therapy in surgical site infections (SSIs). Examples of soft-tissue infections from MRSA include ulcers, impetigo, abscesses, and SSIs. In surgical wounds, evidence is weak (high risk of bias) that linezolid may be better than vancomycin to eradicate MRSA SSIs. […] MRSA colonization is also found in nonsurgical wounds such as traumatic wounds, burns, and chronic ulcers (i.e.: diabetic ulcer, pressure ulcer, arterial insufficiency ulcer, venous ulcer). No conclusive evidence has been found about the best antibiotic regimen to treat MRSA colonization.

• #14 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482221/

  Based on the antibiotic susceptibilities, Methicillin resistance in S. aureus is defined as an oxacillin minimum inhibitory concentration (MIC) of greater than or equal to 4 micrograms/mL. […] This activity reviews the evaluation and management of MRSA and highlights the role of the interprofessional team in the recognition and management of this condition. […] Describe the recommended management of MRSA. […] The selection of empiric antibiotic therapy for the treatment of MRSA infection depends on the type of disease, local S. aureus resistance patterns, availability of the drug, side effect profile, and individual patient profile. […] For most uncomplicated SSTIs suspected of MRSA infection, empirical treatment is with oral antibiotics like trimethoprim/sulfamethoxazole, tetracyclines, such as doxycycline or minocycline, and clindamycin.

• #15 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics/print

  MRSA TREATMENT […] If MRSA infection is diagnosed, you will be given an antibiotic. There are now a large number of antibiotics that can be successfully used to treat MRSA infections. The antibiotic dose or type may be changed when the results of the laboratory culture are available. […] […] At home — Treatment of MRSA at home usually includes a 7- to 10-day course of an antibiotic (by mouth) such as trimethoprim-sulfamethoxazole (brand name: Bactrim), clindamycin, minocycline, linezolid, or doxycycline. It is very important to carefully follow the instructions for taking the antibiotic; this means taking it on time and finishing the entire course of treatment. If the oral antibiotic is not effective or if the infection is making you ill, your doctor might try a different antibiotic instead, including administering antibiotics into your blood, or you may need to be treated in the hospital. (See 'In the hospital’ below.) […]

• #16 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics

  MRSA TREATMENT […] If MRSA infection is diagnosed, you will be given an antibiotic. There are now a large number of antibiotics that can be successfully used to treat MRSA infections. The antibiotic dose or type may be changed when the results of the laboratory culture are available. […] At home — Treatment of MRSA at home usually includes a 7- to 10-day course of an antibiotic (by mouth) such as trimethoprim-sulfamethoxazole (brand name: Bactrim), clindamycin, minocycline, linezolid, or doxycycline. It is very important to carefully follow the instructions for taking the antibiotic; this means taking it on time and finishing the entire course of treatment. If the oral antibiotic is not effective or if the infection is making you ill, your doctor might try a different antibiotic instead, including administering antibiotics into your blood, or you may need to be treated in the hospital.

• #17 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics

  MRSA TREATMENT […] If MRSA infection is diagnosed, you will be given an antibiotic. There are now a large number of antibiotics that can be successfully used to treat MRSA infections. The antibiotic dose or type may be changed when the results of the laboratory culture are available. […] At home — Treatment of MRSA at home usually includes a 7- to 10-day course of an antibiotic (by mouth) such as trimethoprim-sulfamethoxazole (brand name: Bactrim), clindamycin, minocycline, linezolid, or doxycycline. It is very important to carefully follow the instructions for taking the antibiotic; this means taking it on time and finishing the entire course of treatment. If the oral antibiotic is not effective or if the infection is making you ill, your doctor might try a different antibiotic instead, including administering antibiotics into your blood, or you may need to be treated in the hospital.

• #18 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482221/

  Intravenous vancomycin is the drug of choice for most MRSA infections seen in hospitalized patients. […] Daptomycin is a suitable parenteral alternative when vancomycin is not available or not being tolerated. […] The duration of therapy for treatment of MRSA SSTIs may range from 5 to 14 days depending on the extent of infection and response to treatment. […] Source control is a significant part of the treatment for MRSA bacteremia along with empiric MRSA coverage until the susceptibility results are available. […] The 2015 American Heart Association (AHA) guidelines recommend intravenous vancomycin as the first line treatment for endocarditis. […] Follow-up cultures should be repeated to document clearance of the infection from the bloodstream.

• #19 MRSA Diagnosis and Treatment: Antibiotics, Drainage, and More

  https://www.webmd.com/skin-problems-and-treatments/understanding-mrsa-detection-treatment

  MRSA is treatable. By definition, MRSA is resistant to some antibiotics. But other kinds of antibiotics still work. If you have a severe infection, or MRSA in the bloodstream, you will need intravenous antibiotics. Unfortunately, there is emerging antibiotic resistance being seen with some of these medications. […] Antibiotics, however, aren’t always necessary. If you have a small skin boil caused by MRSA, your doctor may just make an incision and drain it. […] If you are prescribed antibiotics, follow your health care provider’s instructions precisely. Never stop taking your medicine, even if you’re feeling better. If you don’t take all of your medicine, some of the staph bacteria may survive, requiring re-treatment. Inadequate treatment also increases the development of antibiotic resistance in the surviving staph population. If you still have staph you can infect someone else.

• #20 MRSA: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/10634

  MRSA is a common and potentially serious infection that has developed resistance to several types of antibiotics. These include methicillin and related antibiotics, such as penicillin, vancomycin, and oxacillin. This resistance makes MRSA difficult to treat. […] Although doctors can no longer use methicillin to treat MRSA, this does not mean that the infection is untreatable. Some antibiotics are effective in treating it. […] The type of treatment for MRSA will depend on the following factors: the type and location of the infection, the severity of the symptoms, the antibiotics to which the strain of MRSA responds. […] The bacteria that cause MRSA are resistant to some but not all antibiotics. A doctor will prescribe medication that is suitable for the particular infection that occurs. […] A person should make sure that they take the whole course of antibiotics exactly as the doctor prescribes. Some people stop taking the drugs after the symptoms disappear, but this can increase the risk of the infection coming back and becoming resistant to treatment.

• #21 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics

  In addition to antibiotics, your health care provider may drain the infected area by inserting a needle or making a small cut in the skin. This is done to reduce the amount of infected material (pus), which will help the tissue to heal. […] In some cases, additional strategies may be used for management of household spread and/or recurrent infection. These may include use of mupirocin ointment, chlorhexidine soap or mouthwash, and other techniques. These strategies are not always fully effective. […] In the hospital — Hospitalized people with MRSA infections are usually treated with an intravenous medication. The intravenous antibiotic is usually continued until the person is improving. […] In many cases, the person will be given antibiotics after discharge from the hospital, either by mouth or by intravenous (IV). This may be needed for a short period of time or for as long as six to eight weeks. Intravenous antibiotics can be given at home, by a visiting nurse, or in a rehabilitation facility. […] In the hospital, if you are colonized but not infected with MRSA, you may be treated with mupirocin ointment and chlorhexidine soap.

• #22 MRSA (Staph) Infection: Pictures, Symptoms, Treatment, and Prevention

  https://www.healthline.com/health/mrsa

  Though a MRSA infection can be serious, it may be treated effectively with certain antibiotics. […] HA-MRSA infections have the capability of producing severe and life-threatening infections. These infections usually require antibiotics through an IV, sometimes for long periods of time depending on the severity of your infection. […] CA-MRSA infections will usually improve with oral antibiotics alone. If you have a large enough skin infection, your doctor may decide to perform an incision and drainage. […] Incision and drainage are typically performed in an office setting under local anesthesia. Your doctor will use a scalpel to cut open the area of infection and drain it completely. You may not need antibiotics if this is performed. […] Essential oils may help treat bacterial infections, such as MRSA. However, further research is still needed to confirm the effectiveness.

• #23 Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5204005/

  Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available. […] Vancomycin or daptomycin are the agents of choice for treatment of invasive MRSA infections. Alternative agents that may be used for second-line or salvage therapy include telavancin, ceftaroline, and linezolid. Recent studies of treatment of MRSA bacteremia are reviewed. […] In general, if there is a poor clinical response to vancomycin regardless of MIC, but especially if vancomycin MIC approaches the upper limit of the susceptible ranges (2 g/mL), it should be discontinued and therapy switched to an alternative agent, typically daptomycin.

• #24 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482221/

  Intravenous vancomycin is the drug of choice for most MRSA infections seen in hospitalized patients. […] Daptomycin is a suitable parenteral alternative when vancomycin is not available or not being tolerated. […] The duration of therapy for treatment of MRSA SSTIs may range from 5 to 14 days depending on the extent of infection and response to treatment. […] Source control is a significant part of the treatment for MRSA bacteremia along with empiric MRSA coverage until the susceptibility results are available. […] The 2015 American Heart Association (AHA) guidelines recommend intravenous vancomycin as the first line treatment for endocarditis. […] Follow-up cultures should be repeated to document clearance of the infection from the bloodstream.

• #25 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics/print

  In addition to antibiotics, your health care provider may drain the infected area by inserting a needle or making a small cut in the skin. This is done to reduce the amount of infected material (pus), which will help the tissue to heal. […] […] In the hospital — Hospitalized people with MRSA infections are usually treated with an intravenous medication. The intravenous antibiotic is usually continued until the person is improving. […] […] In many cases, the person will be given antibiotics after discharge from the hospital, either by mouth or by intravenous (IV). This may be needed for a short period of time or for as long as six to eight weeks. Intravenous antibiotics can be given at home, by a visiting nurse, or in a rehabilitation facility. […] […] In the hospital, if you are colonized but not infected with MRSA, you may be treated with mupirocin ointment and chlorhexidine soap.

• #26 Incidence, prevalence, and management of MRSA bacteremia across patient populations—a review of recent developments in MRSA management and treatment | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1801-3

  Methicillin-resistant Staphylococcus aureus (MRSA) infection is still a major global healthcare problem. […] Management of S. aureus bacteremia involves timely identification of the infecting strain and source of infection, proper choice of antibiotic treatment, and robust prevention strategies. […] For MRSA, the 2011 Infectious Diseases Society of America guidelines recommend treatment with vancomycin or daptomycin. […] Several issues restrict the utility of vancomycin, including slow bactericidal activity, low tissue penetration, and increasing reports of resistance and failure. […] While daptomycin is effective against MRSA bacteremia, treatment-emergent nonsusceptibility is concerning, and evidence suggests prior vancomycin treatment may encourage daptomycin resistance in S. aureus.

• #27 Incidence, prevalence, and management of MRSA bacteremia across patient populations—a review of recent developments in MRSA management and treatment | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1801-3

  Given the substantial morbidity and mortality associated with SAB and the limitations of currently approved treatments, there is a need to identify alternative agents for the treatment of MRSA bacteremia. […] Empirical treatment decisions in MRSA bacteremia require consideration of the prevalence and resistance profile of local strains, risk factors for a complicated clinical course, presence of comorbidities, concurrent interventions, and response to prior antibiotics. […] For most cases of MRSA bacteremia, vancomycin or daptomycin is the recommended treatment. […] Reports of MRSA isolates resistant or nonsusceptible to currently available antibiotics, including vancomycin, daptomycin, and ceftaroline, as well as multidrug-resistant MRSA clones, are a concerning trend. […] Although vancomycin is the first-line antibiotic for MRSA bacteremia treatment, it has a relatively slow onset of bactericidal activity and poorly penetrates some tissues.

• #28 Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-beyond-the-basics/print

  In addition to antibiotics, your health care provider may drain the infected area by inserting a needle or making a small cut in the skin. This is done to reduce the amount of infected material (pus), which will help the tissue to heal. […] […] In the hospital — Hospitalized people with MRSA infections are usually treated with an intravenous medication. The intravenous antibiotic is usually continued until the person is improving. […] […] In many cases, the person will be given antibiotics after discharge from the hospital, either by mouth or by intravenous (IV). This may be needed for a short period of time or for as long as six to eight weeks. Intravenous antibiotics can be given at home, by a visiting nurse, or in a rehabilitation facility. […] […] In the hospital, if you are colonized but not infected with MRSA, you may be treated with mupirocin ointment and chlorhexidine soap.

• #29 MRSA: Causes, Symptoms, Diagnosis, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/11633-methicillin-resistant-staphylococcus-aureus-mrsa

  MRSA infections are hard to treat because very few antibiotics are effective against them. […] Providers treat MRSA infections by caring for open wounds and finding antibiotics that are effective against the strain of MRSA you have. Wound treatment includes draining fluid and surgically removing infected tissue. […] Antibiotics a provider might use to treat MRSA include: Vancomycin, Rifampin, Trimethoprim/sulfamethoxazole (TMP/SMX), Ceftaroline, Linezolid, Daptomycin, Clindamycin, Doxycycline, Delafloxacin. […] Sometimes, MRSA is called a superbug because its defense mechanisms against so many antibiotics make it hard to treat. One strategy providers might use is to treat you with more than one type of antibiotic at a time. […] If you have a skin infection, your provider will surgically treat and drain your wounds. They might give you topical or oral antibiotics. You’ll need to be treated in the hospital if you have a severe or invasive MRSA infection. […] Yes, more than half of all MRSA cases are cured with antibiotics, and providers successfully treat most MRSA skin infections. But serious infections like pneumonia, endocarditis and bacteremia can quickly get worse before a provider can find a treatment that works.

• #30 Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review

  https://www.mdpi.com/2079-6382/11/5/606

  Synergistic or combination therapy is a new approach against resistant microorganisms such as MRSA, VRSA, etc. […] The combination of drugs shows better results than the activity of individual medications. Hence, unique and effective drugs against resistant bacteria can be discovered via this method. […] Bacteriophage therapy, or phage therapy, is a cost-effective treatment method that uses viruses to treat bacterial infections. […] The high antibiotic resistance profile of MRSA indicates the need for new interventions such as vaccines and new antibiotics. […] Vancomycin is mainly used to treat MRSA infections, either alone or in combination. […] The combination of antibiotics with NPs can accomplish all the requirements of an effective antibacterial agent and save millions of lives.

• #31 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  A preferred regimen for persistent bacteremia, however, has yet to be established as most data is only available from case reports or series. […] The addition of a beta-lactam to daptomycin improves daptomycin binding to the cell membrane leading to an increase in net cell membrane surface charge and ultimately cell death. […] Adding an antistaphylococcal beta-lactam to daptomycin is a reasonable option when treating persistent MRSA bacteremia. […] A recent clinical study of MRSA bacteremia was terminated early due to a significant difference in the mortality rate of daptomycin plus ceftaroline (0%) compared to standard monotherapy (26%), which was mainly vancomycin. […] Combination therapy of daptomycin and sulfamethoxazole-trimethoprim has demonstrated in vitro synergy by increased inhibition of folate synthesis, although the exact mechanism is unknown.

• #32 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  Although linezolid is an option for S. aureus bacteremia, it is not FDA approved and is often not the preferred agent due to its bacteriostatic activity and large volume of distribution. […] Lastly, rifampin in combination with daptomycin for persistent bacteremia potentially provides additional benefit due to the ability of rifampin to target biofilm. […] Many combination antibiotic regimens have been shown to be successful in patients that have MRSA bacteremia lasting more than 7 days. Daptomycin-based combinations seem promising.

• #33 Staphylococcus Aureus Infection Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/971358-treatment

  In patients with MRSA, combinations of vancomycin with aminoglycosides should be used. […] In all cases the aminoglycoside is only added for the first 3 days. […] Rifampin, because of its lipid solubility, is another potent agent when used in combination with nafcillin and gentamicin or vancomycin and gentamicin, especially in patients with prosthetic valve endocarditis. […] Rifampin should never be used alone because resistance can develop. […] The response to therapy is usually slow, and patients may continue to have bacteremia, fever, and leukocytosis for at least a week after therapy is initiated. […] Some authors recommend obtaining blood cultures after the end of therapy. […] Treatment with antibiotics is specific to the etiologic agent and its characteristics.

• #34 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  A preferred regimen for persistent bacteremia, however, has yet to be established as most data is only available from case reports or series. […] The addition of a beta-lactam to daptomycin improves daptomycin binding to the cell membrane leading to an increase in net cell membrane surface charge and ultimately cell death. […] Adding an antistaphylococcal beta-lactam to daptomycin is a reasonable option when treating persistent MRSA bacteremia. […] A recent clinical study of MRSA bacteremia was terminated early due to a significant difference in the mortality rate of daptomycin plus ceftaroline (0%) compared to standard monotherapy (26%), which was mainly vancomycin. […] Combination therapy of daptomycin and sulfamethoxazole-trimethoprim has demonstrated in vitro synergy by increased inhibition of folate synthesis, although the exact mechanism is unknown.

• #35 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  A preferred regimen for persistent bacteremia, however, has yet to be established as most data is only available from case reports or series. […] The addition of a beta-lactam to daptomycin improves daptomycin binding to the cell membrane leading to an increase in net cell membrane surface charge and ultimately cell death. […] Adding an antistaphylococcal beta-lactam to daptomycin is a reasonable option when treating persistent MRSA bacteremia. […] A recent clinical study of MRSA bacteremia was terminated early due to a significant difference in the mortality rate of daptomycin plus ceftaroline (0%) compared to standard monotherapy (26%), which was mainly vancomycin. […] Combination therapy of daptomycin and sulfamethoxazole-trimethoprim has demonstrated in vitro synergy by increased inhibition of folate synthesis, although the exact mechanism is unknown.

• #36 IDSA Guidelines on the Treatment of MRSA Infections in Adults and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0815/p455.html

  For hospitalized patients with complicated skin and soft-tissue infections (i.e., deeper soft-tissue infections, surgical or traumatic wound infection, major abscesses, cellulitis, or infected ulcers and burns), empiric therapy for MRSA should be considered pending culture results, in addition to surgical debridement and broad-spectrum antibiotics. […] Treatment for seven to 14 days is recommended, but should be individualized to the patient’s clinical response. […] In children with minor skin infections (e.g., impetigo) or secondarily infected lesions (e.g., eczema, ulcers, lacerations), treatment with mupirocin 2% topical cream (Bactroban) is recommended. […] Vancomycin is recommended in hospitalized children. […] Empiric therapy for MRSA is recommended, pending sputum and/or blood culture results, for hospitalized patients with severe community-acquired pneumonia defined by one of the following: a requirement for admission to the intensive care unit, necrotizing or cavitary infiltrates, or empyema.

• #37 IDSA Guidelines on the Treatment of MRSA Infections in Adults and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0815/p455.html

  In children, intravenous vancomycin is recommended for treating MRSA pneumonia. […] The mainstay of therapy for osteomyelitis is surgical debridement with drainage of associated soft-tissue abscesses. […] The optimal duration of therapy for MRSA osteomyelitis is unknown, although a minimum of eight weeks is recommended. […] For patients with septic arthritis, the antibiotic choices for osteomyelitis are recommended; a three- to four-week course of therapy is suggested. […] Recommended treatment for patients with meningitis is intravenous vancomycin for two weeks. […] The recommended treatment of neonatal MRSA sepsis is intravenous vancomycin, with dosing as outlined in Red Book.

• #38 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482221/

  Intravenous vancomycin is the drug of choice for most MRSA infections seen in hospitalized patients. […] Daptomycin is a suitable parenteral alternative when vancomycin is not available or not being tolerated. […] The duration of therapy for treatment of MRSA SSTIs may range from 5 to 14 days depending on the extent of infection and response to treatment. […] Source control is a significant part of the treatment for MRSA bacteremia along with empiric MRSA coverage until the susceptibility results are available. […] The 2015 American Heart Association (AHA) guidelines recommend intravenous vancomycin as the first line treatment for endocarditis. […] Follow-up cultures should be repeated to document clearance of the infection from the bloodstream.

• #39 IDSA Guidelines on the Treatment of MRSA Infections in Adults and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0815/p455.html

  For hospitalized patients with complicated skin and soft-tissue infections (i.e., deeper soft-tissue infections, surgical or traumatic wound infection, major abscesses, cellulitis, or infected ulcers and burns), empiric therapy for MRSA should be considered pending culture results, in addition to surgical debridement and broad-spectrum antibiotics. […] Treatment for seven to 14 days is recommended, but should be individualized to the patient’s clinical response. […] In children with minor skin infections (e.g., impetigo) or secondarily infected lesions (e.g., eczema, ulcers, lacerations), treatment with mupirocin 2% topical cream (Bactroban) is recommended. […] Vancomycin is recommended in hospitalized children. […] Empiric therapy for MRSA is recommended, pending sputum and/or blood culture results, for hospitalized patients with severe community-acquired pneumonia defined by one of the following: a requirement for admission to the intensive care unit, necrotizing or cavitary infiltrates, or empyema.

• #40 MRSA: Symptoms, Causes, Treatments, and Your Risk

  https://www.webmd.com/skin-problems-and-treatments/understanding-mrsa

  The treatment that you need depends on what kind of infection you have and where it is. For example, it may be limited to a skin infection, or the bacteria may have entered your bloodstream. […] Treatment may include: […] Draining fluid from an abscess […] Surgically removing tissue that’s infected […] Prescribing antibiotics that can treat MRSA. […] If you have only a skin infection, you might not need any antibiotics. But it’s important that you don’t try to drain the abscess yourself because you can make the infection worse. Be sure to get treatment from a health care provider. […] While MRSA skin infections can usually be treated in your doctor’s office, severe infections will land you in the hospital. You’ll get antibiotics through an IV to help kill the infection. […] Although strands of HA-MRSA and CA-MRSA come from the same bacterium, Staphylococcus aureus, they have different levels of resistance and virulence the ability to infect and cause disease. HA-MRSA is resistant to more types of antibiotics than CA-MRSA is.

• #41 Recommended Treatments for Community-Acquired MRSA Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0501/p802.html

  Community-acquired MRSA skin and soft-tissue infections, such as pustules, furuncles, and small abscesses, usually respond to incision and drainage. This may be sufficient to treat small, uncomplicated purulent lesions, although clear evidence is lacking. More complicated lesions (i.e., those with surrounding cellulitis or no drainable foci) are usually treated with antimicrobial agents. Patients with fever or other systemic symptoms are also usually treated with antimicrobial agents. […] Trimethoprim/sulfamethoxazole (TMP/SMX; Bactrim, Septra) is the agent most commonly used to treat adults with community-acquired MRSA infections in the United States. In vitro evidence suggests TMP/SMX has greater bactericidal activity against community-acquired MRSA than linezolid (Zyvox), rifampin (Rifadin), clindamycin (Cleocin), or minocycline (Minocin). A retrospective review showed TMP/SMX to be effective for skin and soft-tissue infections.

• #42 Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infections

  https://www.uspharmacist.com/article/methicillin-resistant-staphylococcus-aureus-skin-and-soft-tissue-infections

  Before antimicrobial therapy is discussed, it is important to note that incision and drainage of fluctuant lesions is shown to have benefit in studies and is recommended by current guidelines. Oral treatment options for MRSA SSTIs, as stated by the guidelines, are clindamycin, doxycycline, minocycline, and TMP-SMZ. IV options include daptomycin, linezolid, and vancomycin, the latter being the parenteral drug of choice. More data from controlled clinical trials are needed to establish optimal regimens for the treatment of MRSA SSTIs. […] Any patient with potential for MRSA, when sent home with a treatment regimen, should be reevaluated in 24 to 48 hours to ensure clinical response. If the infection is progressing, it could be due to a resistant strain or a deeper underlying infection. […] In a study conducted in the second half of 2006, 332 emergency room (ER) physicians were surveyed regarding treatment of MRSA SSTIs. If MRSA was suspected in a patient who was well enough to be discharged home from the ER, these physicians would prescribe, alone or in combination, the following drugs: vancomycin (18%), TMP-SMZ (55%), clindamycin (22%), rifampin (14%), and cephalexin (14%). Patients who required admission were given vancomycin IV (65%), TMP-SMZ (15%), and linezolid (4%).

• #43 Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infections

  https://www.uspharmacist.com/article/methicillin-resistant-staphylococcus-aureus-skin-and-soft-tissue-infections

  Before antimicrobial therapy is discussed, it is important to note that incision and drainage of fluctuant lesions is shown to have benefit in studies and is recommended by current guidelines. Oral treatment options for MRSA SSTIs, as stated by the guidelines, are clindamycin, doxycycline, minocycline, and TMP-SMZ. IV options include daptomycin, linezolid, and vancomycin, the latter being the parenteral drug of choice. More data from controlled clinical trials are needed to establish optimal regimens for the treatment of MRSA SSTIs. […] Any patient with potential for MRSA, when sent home with a treatment regimen, should be reevaluated in 24 to 48 hours to ensure clinical response. If the infection is progressing, it could be due to a resistant strain or a deeper underlying infection. […] In a study conducted in the second half of 2006, 332 emergency room (ER) physicians were surveyed regarding treatment of MRSA SSTIs. If MRSA was suspected in a patient who was well enough to be discharged home from the ER, these physicians would prescribe, alone or in combination, the following drugs: vancomycin (18%), TMP-SMZ (55%), clindamycin (22%), rifampin (14%), and cephalexin (14%). Patients who required admission were given vancomycin IV (65%), TMP-SMZ (15%), and linezolid (4%).

• #44 Antibiotic Options for MRSA Bacteremia: Are We Still Stuck in “Mississippi Mud?”

  https://www.contagionlive.com/view/antibiotic-options-for-mrsa-bacteremia-are-we-still-stuck-in-mississippi-mud-

  Staphylococcus aureus bacteremia (SAB) has been a constant and growing problem in different communities and health care settings. […] Due to the large health care burden imposed by SAB, different antibiotics have been used to address this issue and new antibiotics are being evaluated as an option for MRSA bacteremia. This article reviews the current standard of therapy for MRSA bacteremia as well as alternative antibiotic options and the evidence for their use. […] Vancomycin has been the gold standard therapy for MRSA bacteremia for decades as well as empirical therapy for possible gram-positive infections. […] There is an ongoing debate regarding vancomycin use as the drug of choice for MRSA bacteremia due to concerns about worse outcomes with elevated vancomycin minimum inhibitory concentration (MIC) and difficulty with therapeutic drug monitoring.

• #45 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482221/

  Intravenous vancomycin is the drug of choice for most MRSA infections seen in hospitalized patients. […] Daptomycin is a suitable parenteral alternative when vancomycin is not available or not being tolerated. […] The duration of therapy for treatment of MRSA SSTIs may range from 5 to 14 days depending on the extent of infection and response to treatment. […] Source control is a significant part of the treatment for MRSA bacteremia along with empiric MRSA coverage until the susceptibility results are available. […] The 2015 American Heart Association (AHA) guidelines recommend intravenous vancomycin as the first line treatment for endocarditis. […] Follow-up cultures should be repeated to document clearance of the infection from the bloodstream.

• #46 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  Methicillin-resistant Staphyloccous aureus (MRSA) is a bacteria that can cause a wide variety of infections, including skin or soft tissue infections and bloodstream infections (bacteremia). […] Current MRSA bacteremia practice guidelines by the Infectious Disease Society of America (IDSA) recommend the use of vancomycin or daptomycin as first-line treatment options for bacteremia. […] An important step in persistent MRSA bacteremia treatment is identifying all possible sources of infection and obtaining source control through drainage or surgical debridement. […] If first-line therapy fails, IDSA guidelines recommend a change in therapy rather than adding an additional agent. Recommendations include high-dose daptomycin at 10 mg/kg daily, if susceptible, in combination with another agent.

• #47 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  Methicillin-resistant Staphyloccous aureus (MRSA) is a bacteria that can cause a wide variety of infections, including skin or soft tissue infections and bloodstream infections (bacteremia). […] Current MRSA bacteremia practice guidelines by the Infectious Disease Society of America (IDSA) recommend the use of vancomycin or daptomycin as first-line treatment options for bacteremia. […] An important step in persistent MRSA bacteremia treatment is identifying all possible sources of infection and obtaining source control through drainage or surgical debridement. […] If first-line therapy fails, IDSA guidelines recommend a change in therapy rather than adding an additional agent. Recommendations include high-dose daptomycin at 10 mg/kg daily, if susceptible, in combination with another agent.

• #48 Pharm2Exam Table: What is persistent MRSA bacteremia and how is it treated? – Division of Infectious Diseases | Division of Infectious Diseases | University of Nebraska Medical Center

  https://blog.unmc.edu/infectious-disease/2019/07/22/pharm2exam-table-what-is-persistent-mrsa-bacteremia-and-how-is-it-treated/

  A preferred regimen for persistent bacteremia, however, has yet to be established as most data is only available from case reports or series. […] The addition of a beta-lactam to daptomycin improves daptomycin binding to the cell membrane leading to an increase in net cell membrane surface charge and ultimately cell death. […] Adding an antistaphylococcal beta-lactam to daptomycin is a reasonable option when treating persistent MRSA bacteremia. […] A recent clinical study of MRSA bacteremia was terminated early due to a significant difference in the mortality rate of daptomycin plus ceftaroline (0%) compared to standard monotherapy (26%), which was mainly vancomycin. […] Combination therapy of daptomycin and sulfamethoxazole-trimethoprim has demonstrated in vitro synergy by increased inhibition of folate synthesis, although the exact mechanism is unknown.

• #49 Treatment Options for Methicillin-Resistant Staphylococcus Aureus Pneumonia Evaluated

  https://www.pulmonologyadvisor.com/news/treatment-options-for-methicillin-resistant-staphylococcus-aureus-pneumonia-evaluated/

  Evidence for the treatment of MRSA pneumonia with trimethoprim-sulfamethoxazole, clindamycin, doxycycline, or minocycline was found to be based on limited data. […] Currently, the Infectious Disease Society of America (IDSA) recommends vancomycin and linezolid for the treatment of MRSA pneumonia, although the former has been associated with low clinical success rates and the latter with significant toxicities. […] Although recommended as a second line agent for MRSA pneumonia, evidence for the use of clindamycin as monotherapy or in combination with other antibiotics was found to be limited. […] If clindamycin is to be considered for MRSA pneumonia treatment, it is important to ensure that the isolate is susceptible and D-testing is used to rule out any inducible resistance because S aureus susceptibilities to clindamycin have decreased to 40% over the past few years in the United States, the authors stated.

• #50 Treatment Options for Methicillin-Resistant Staphylococcus Aureus Pneumonia Evaluated

  https://www.pulmonologyadvisor.com/news/treatment-options-for-methicillin-resistant-staphylococcus-aureus-pneumonia-evaluated/

  Evidence for the treatment of MRSA pneumonia with trimethoprim-sulfamethoxazole, clindamycin, doxycycline, or minocycline was found to be based on limited data. […] Currently, the Infectious Disease Society of America (IDSA) recommends vancomycin and linezolid for the treatment of MRSA pneumonia, although the former has been associated with low clinical success rates and the latter with significant toxicities. […] Although recommended as a second line agent for MRSA pneumonia, evidence for the use of clindamycin as monotherapy or in combination with other antibiotics was found to be limited. […] If clindamycin is to be considered for MRSA pneumonia treatment, it is important to ensure that the isolate is susceptible and D-testing is used to rule out any inducible resistance because S aureus susceptibilities to clindamycin have decreased to 40% over the past few years in the United States, the authors stated.

• #51 Methicillin-resistant Staphylococcus aureus – Wikipedia

  https://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

  Treatment of MRSA infection is urgent and delays can be fatal. The location and history related to the infection determines the treatment. The route of administration of an antibiotic varies. Antibiotics effective against MRSA can be given by IV, oral, or a combination of both, and depend on the specific circumstances and patient characteristics. The use of concurrent treatment with vancomycin or other beta-lactam agents may have a synergistic effect. […] Both CA-MRSA and HA-MRSA are resistant to traditional anti-staphylococcal beta-lactam antibiotics, such as cephalexin. CA-MRSA has a greater spectrum of antimicrobial susceptibility to sulfa drugs (like co-trimoxazole (trimethoprim/sulfamethoxazole), tetracyclines (like doxycycline and minocycline) and clindamycin (for osteomyelitis). MRSA can be eradicated with a regimen of linezolid, though treatment protocols vary and serum levels of antibiotics vary widely from person to person and may affect outcomes. The effective treatment of MRSA with linezolid has been successful in 87% of people. Linezolid is more effective in soft tissue infections than vancomycin. This is compared to eradication of infection in those with MRSA treated with vancomycin. Treatment with vancomycin is successful in approximately 49% of people. Linezolid belongs to the newer oxazolidinone class of antibiotics which has been shown to be effective against both CA-MRSA and HA-MRSA. The Infectious Disease Society of America recommends vancomycin, linezolid, or clindamycin (if susceptible) for treating those with MRSA pneumonia. Ceftaroline, a fifth-generation cephalosporin, is the first beta-lactam antibiotic approved in the US to treat MRSA infections in skin and soft tissue or community-acquired pneumonia.

• #52 Antibiotic Options for MRSA Bacteremia: Are We Still Stuck in “Mississippi Mud?”

  https://www.contagionlive.com/view/antibiotic-options-for-mrsa-bacteremia-are-we-still-stuck-in-mississippi-mud-

  Infectious Diseases Society of America guidelines recommend that for vancomycin MIC of 2 g/mL or more, an alternative antibiotic should be chosen; for those with MIC of 2 g/mL or less, the patients clinical and microbiologic response should dictate continued vancomycin use. […] A more recent meta-analysis by Ishaq et al showed that overall mortality and complicated bacteremia were not significantly associated with high vancomycin MIC in a patient with MRSA bacteremia and that more randomized clinical trials (RCTs) are needed to assess the utility of vancomycin MIC values in predicting mortality and other adverse outcomes. […] Daptomycin is a cyclic lipopeptide antibiotic that is rapidly bactericidal against MSSA and MRSA. […] Despite its bactericidal activity and excellent skin and soft tissue penetration, daptomycin has been shown to be clinically ineffective in bronchoalveolar pneumonia (BAP).

• #53 Treatment Options for Methicillin-Resistant Staphylococcus Aureus Pneumonia Evaluated

  https://www.pulmonologyadvisor.com/news/treatment-options-for-methicillin-resistant-staphylococcus-aureus-pneumonia-evaluated/

  Even though TMP-SMX, clindamycin, doxycycline, and minocycline have good bioavailability and lung penetration, which are ideal characteristics, the evidence for their use in MRSA pneumonia remains indeterminate, the study authors concluded. […] Clinicians should base their preference to use these agents on susceptibility results and determine their utility on a case-by-case basis. […] They added that further clinical studies are needed to validate the effectiveness of these agents.

• #54 IDSA Guidelines on the Treatment of MRSA Infections in Adults and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0815/p455.html

  In children, intravenous vancomycin is recommended for treating MRSA pneumonia. […] The mainstay of therapy for osteomyelitis is surgical debridement with drainage of associated soft-tissue abscesses. […] The optimal duration of therapy for MRSA osteomyelitis is unknown, although a minimum of eight weeks is recommended. […] For patients with septic arthritis, the antibiotic choices for osteomyelitis are recommended; a three- to four-week course of therapy is suggested. […] Recommended treatment for patients with meningitis is intravenous vancomycin for two weeks. […] The recommended treatment of neonatal MRSA sepsis is intravenous vancomycin, with dosing as outlined in Red Book.

• #55 IDSA Guidelines on the Treatment of MRSA Infections in Adults and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0815/p455.html

  In children, intravenous vancomycin is recommended for treating MRSA pneumonia. […] The mainstay of therapy for osteomyelitis is surgical debridement with drainage of associated soft-tissue abscesses. […] The optimal duration of therapy for MRSA osteomyelitis is unknown, although a minimum of eight weeks is recommended. […] For patients with septic arthritis, the antibiotic choices for osteomyelitis are recommended; a three- to four-week course of therapy is suggested. […] Recommended treatment for patients with meningitis is intravenous vancomycin for two weeks. […] The recommended treatment of neonatal MRSA sepsis is intravenous vancomycin, with dosing as outlined in Red Book.

• #56 Staphylococcus Aureus Infection Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/971358-treatment

  Empirically, initiating a semisynthetic penicillin (eg, oxacillin [150 mg/kg/d]) and clindamycin (30-40 mg/kg/d) is a good choice for most cases of community-acquired osteomyelitis. […] In patients with allergy to penicillin, a first-generation cephalosporin and clindamycin (30-40 mg/kg/d) are an excellent alternative. […] Use vancomycin or linezolid when the other drugs mentioned are absolutely not tolerated or when resistance or the clinical course dictates. […] The duration of therapy is a controversial topic in the literature, but the consensus among multiple authors is that the minimum effective treatment time is 4-6 weeks. […] A switch to oral therapy is acceptable if the child is able to take oral antibiotics, is afebrile, and if he or she has demonstrated a good clinical response to parenteral antibiotics.

• #57 IDSA Guidelines on the Treatment of MRSA Infections in Adults and Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0815/p455.html

  In children, intravenous vancomycin is recommended for treating MRSA pneumonia. […] The mainstay of therapy for osteomyelitis is surgical debridement with drainage of associated soft-tissue abscesses. […] The optimal duration of therapy for MRSA osteomyelitis is unknown, although a minimum of eight weeks is recommended. […] For patients with septic arthritis, the antibiotic choices for osteomyelitis are recommended; a three- to four-week course of therapy is suggested. […] Recommended treatment for patients with meningitis is intravenous vancomycin for two weeks. […] The recommended treatment of neonatal MRSA sepsis is intravenous vancomycin, with dosing as outlined in Red Book.

• #58 Decolonisation treatment for people with MRSA

  https://www.healthywa.wa.gov.au/Articles/A_E/Decolonisation-treatment-for-people-with-MRSA

  Decolonisation is when topical treatments are used to try and get rid of methicillin resistant staphylococcus aureus (MRSA). […] It involves the use of an antiseptic body wash and nasal ointment for 5 days. […] Decolonisation treatment can reduce the risk of recurrent MRSA infections or spreading MRSA to others. […] Decolonisation can reduce the risk of you getting recurrent infections or spreading the MRSA to others who share the same household. […] Decolonisation is also recommended when: you have an increased risk of infection due to other existing medical conditions, such as cancer, diabetes or conditions that weaken your immune system; you are planning to have an operation; you are a healthcare worker or carer. […] It is important to stop treatment after five days. Treatments should only be repeated following instructions from your doctor or healthcare provider.

• #59 Decolonisation treatment for people with MRSA

  https://www.healthywa.wa.gov.au/Articles/A_E/Decolonisation-treatment-for-people-with-MRSA

  Decolonisation is when topical treatments are used to try and get rid of methicillin resistant staphylococcus aureus (MRSA). […] It involves the use of an antiseptic body wash and nasal ointment for 5 days. […] Decolonisation treatment can reduce the risk of recurrent MRSA infections or spreading MRSA to others. […] Decolonisation can reduce the risk of you getting recurrent infections or spreading the MRSA to others who share the same household. […] Decolonisation is also recommended when: you have an increased risk of infection due to other existing medical conditions, such as cancer, diabetes or conditions that weaken your immune system; you are planning to have an operation; you are a healthcare worker or carer. […] It is important to stop treatment after five days. Treatments should only be repeated following instructions from your doctor or healthcare provider.

• #60 MRSA infection in the community

  https://www.health.wa.gov.au/Articles/J_M/Management-of-CA-MRSA

  CA-MRSA strains, like all MRSA, are resistant to most beta-lactam antibiotics. […] Incision and drainage (ID) is recommended as a priority, when applicable. […] Prescribe antibiotics if ID is not possible, when there is cellulitis; they are febrile or systemically unwell. […] The decision to recommend decolonisation should follow an assessment of the individual that includes their willingness and capability to comply with the regimen. […] Decolonisation may be offered on a case-by-case basis when individuals or their household contacts have recurrent CA-MRSA or staphylococcal-like infections. […] The choice of antibiotics is dependent on the age, allergy history and co-morbidities of the patient. […] Clindamycin should NOT be used for MRSA isolates RESISTANT to erythromycin and related macrolide class antibiotics. […] Management of CA-MRSA fact sheet for healthcare providers.

• #61 MRSA: Symptoms, Causes, Treatment, and More

  https://www.verywellhealth.com/methicillin-resistant-staphylococcus-aureus-infections-1069436

  Drainage and one or more antibiotics are used for more serious infections. If your illness is severe, you may require hospitalization and an intravenous (IV) antibiotic. You may also require other treatments in the hospital, such as: Intravenous fluid administration, Dialysis (if your kidneys are failing as a result of the MRSA infection), Ventilator placement (to help with breathing, if your lungs are failing as a result of the infection). […] For patients in the hospital who are found to be carriers of MRSA, a decolonization treatment plan may be initiated at hospital discharge. The main goals of decolonization are to prevent MRSA transmission and future infection. […] This treatment may be given for five days, twice per month for six months and consist of the following three therapies: 4% rinse-off chlorhexidine for daily bathing or showering, 0.12% chlorhexidine mouthwash twice daily, 2% nasal mupirocin twice daily. […] For people within the community, decolonization may be recommended for those who keep getting MRSA infections despite optimizing their hygiene practices and/or if there is ongoing MRSA transmission to household members.

• #62 Decolonisation treatment for people with MRSA

  https://www.healthywa.wa.gov.au/Articles/A_E/Decolonisation-treatment-for-people-with-MRSA

  Recommended MRSA nasal ointment and antiseptics: nasal ointment mupirocin 2 per cent (Bactroban) this is available by prescription from your doctor; antiseptic body wash (triclosan 1 per cent or chlorhexidine 4 per cent) available over-the-counter at a pharmacy. […] How to use the nasal ointment apply twice a day for 5 days. […] How to use the body wash use once a day for 5 days.

• #63 Treatment of Meticillin-resistant Staphylococcus aureus (MRSA)

  https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/treatment-of-meticillin-resistant-staphylococcus-aureus-mrsa/

  The best way to treat and reduce the amount of MRSA on your skin is with a combination of prescribed lotions. These will reduce the number of germs on your skin. […] Known as mupirocin or Bactroban must be put inside your nostrils 3 times a day for the first 5 days of treatment. […] An antimicrobial body wash will also be prescribed. […] The purpose of treatment with the nasal cream and antimicrobial body wash is to reduce the MRSA on the skin during your time in hospital. The treatment will also lower the risk of an infection. […] These products must be used together for 5 days. If you are still a patient in hospital after this time, we will ask you to continue to wash with the antimicrobial body wash for the rest of your inpatient stay.

• #64 MRSA Decolonization

  https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/mrsa-decolonization

  Many people have been exposed to a germ called Staphylococcus aureus. Some of these specific germs are resistant to certain antibiotics. They are called Methicillin-resistant Staphylococcus aureus, also known as MRSA. The removal of MRSA is called „decolonization”. Decolonization may help reduce the risk of spreading the germs to others and help to avoid future infections. […] If your practitioner prescribes decolonization, there are two parts to the treatment: Rubbing ointment into each of your nostrils twice a day for 5 days […] Your doctor may prescribe the ointment and soap, as well as oral medicines. […] Apply the nasal ointment two times every day for 5 days unless your doctor tells you otherwise. […] You will be given a prescription for this wash. Use about 2 tablespoons of soap for each application in the shower.

• #65 Decolonisation treatment for people with MRSA

  https://www.healthywa.wa.gov.au/Articles/A_E/Decolonisation-treatment-for-people-with-MRSA

  Decolonisation is when topical treatments are used to try and get rid of methicillin resistant staphylococcus aureus (MRSA). […] It involves the use of an antiseptic body wash and nasal ointment for 5 days. […] Decolonisation treatment can reduce the risk of recurrent MRSA infections or spreading MRSA to others. […] Decolonisation can reduce the risk of you getting recurrent infections or spreading the MRSA to others who share the same household. […] Decolonisation is also recommended when: you have an increased risk of infection due to other existing medical conditions, such as cancer, diabetes or conditions that weaken your immune system; you are planning to have an operation; you are a healthcare worker or carer. […] It is important to stop treatment after five days. Treatments should only be repeated following instructions from your doctor or healthcare provider.

• #66 Treatment of Meticillin-resistant Staphylococcus aureus (MRSA)

  https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/treatment-of-meticillin-resistant-staphylococcus-aureus-mrsa/

  The best way to treat and reduce the amount of MRSA on your skin is with a combination of prescribed lotions. These will reduce the number of germs on your skin. […] Known as mupirocin or Bactroban must be put inside your nostrils 3 times a day for the first 5 days of treatment. […] An antimicrobial body wash will also be prescribed. […] The purpose of treatment with the nasal cream and antimicrobial body wash is to reduce the MRSA on the skin during your time in hospital. The treatment will also lower the risk of an infection. […] These products must be used together for 5 days. If you are still a patient in hospital after this time, we will ask you to continue to wash with the antimicrobial body wash for the rest of your inpatient stay.

• #67 MRSA – information for families | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/general-medical-conditions/mrsa/

  MRSA is short for Meticillin-resistant Staphylococcus aureus. […] This means that non-standard antibiotic medicines are needed to treat an infection with MRSA, which may have more side effects. […] If the child has an MRSA infection, they may need antibiotics given directly into a vein (intravenous infusion). […] Treatment may be advised to reduce this risk by prescribing special antiseptic skin washes and antiseptic nasal ointment. […] Laboratory staff then use this sample of the MRSA to work out which medicines will work best if treatment is needed. […] Infection with MRSA can be treated, and should not recur if treated sufficiently, but because S. aureus is well adapted to live on the skin of people, colonisation with S.aureus, including MRSA, may persist for months or sometimes years.

• #68 MRSA – information for families | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/general-medical-conditions/mrsa/

  Antiseptic skin washes can temporarily reduce the number of MRSA bacteria to a level where it is difficult to detect them through swabbing, but will not usually get rid of them completely. […] MRSA is easily transferred from person to person, so if a child comes into contact with someone else with MRSA, they can get the germs again, even after decolonisation or treatment. […] At GOSH, we do not declare a child free from MRSA until they meet the following criteria: They have had three complete screens clear of MRSA, They have not been in (any) hospital in the previous six months, They have not been on antibiotics in the previous six months, They have no devices that break the skin barrier, such as, for example, a tracheostomy or gastrostomy, They are not immunocompromised. […] We screen every child that is admitted for MRSA. […] Every child who we find to be colonised with MRSA is nursed in isolation precautions (in a room if possible) to prevent the spread to other patients.

• #69 Incidence, prevalence, and management of MRSA bacteremia across patient populations—a review of recent developments in MRSA management and treatment | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1801-3

  Given the substantial morbidity and mortality associated with SAB and the limitations of currently approved treatments, there is a need to identify alternative agents for the treatment of MRSA bacteremia. […] Empirical treatment decisions in MRSA bacteremia require consideration of the prevalence and resistance profile of local strains, risk factors for a complicated clinical course, presence of comorbidities, concurrent interventions, and response to prior antibiotics. […] For most cases of MRSA bacteremia, vancomycin or daptomycin is the recommended treatment. […] Reports of MRSA isolates resistant or nonsusceptible to currently available antibiotics, including vancomycin, daptomycin, and ceftaroline, as well as multidrug-resistant MRSA clones, are a concerning trend. […] Although vancomycin is the first-line antibiotic for MRSA bacteremia treatment, it has a relatively slow onset of bactericidal activity and poorly penetrates some tissues.

• #70 Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review

  https://www.mdpi.com/2079-6382/11/5/606

  Synergistic or combination therapy is a new approach against resistant microorganisms such as MRSA, VRSA, etc. […] The combination of drugs shows better results than the activity of individual medications. Hence, unique and effective drugs against resistant bacteria can be discovered via this method. […] Bacteriophage therapy, or phage therapy, is a cost-effective treatment method that uses viruses to treat bacterial infections. […] The high antibiotic resistance profile of MRSA indicates the need for new interventions such as vaccines and new antibiotics. […] Vancomycin is mainly used to treat MRSA infections, either alone or in combination. […] The combination of antibiotics with NPs can accomplish all the requirements of an effective antibacterial agent and save millions of lives.

• #71 Methicillin-resistant Staphylococcus aureus: novel treatment approach breakthroughs | Bulletin of the National Research Centre | Full Text

  https://bnrc.springeropen.com/articles/10.1186/s42269-023-01072-3

  Vancomycin has remained the medication of choice in treating MRSA infection conditions. […] The Centers for Disease Control and Prevention (CDC) estimates that more than 75,000 persons in the USA are infected with MRSA every year, with the vast majority of healthcare-associated settings occurring in the geriatric population. […] The FDA has permitted five anti-infective agents for treating MRSA-related multidrug resistance: linezolid, daptomycin, tigecycline, telavancin, and ceftaroline. […] A new promising antibacterial therapeutic management system was introduced through the FDA to treat MRSA infection conditions, and the therapy management system is also used in different microbial resistance conditions. […] Despite the commitment of several years, work has centered on improving the treatment of MRSA with a focus on increased activity and efficacy.

• #72 Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review

  https://www.mdpi.com/2079-6382/11/5/606

  MRSA infections can resist the effects of numerous common antibiotics; hence, it is more intricate to treat. […] The world health organization (WHO) has listed MRSA as a “priority pathogen” due to its successful clones and ability to spread life-threatening diseases. […] The Public Health Agency of Canada (PHAC) has regarded MRSA as one of the priority antimicrobial-resistant pathogens. […] Recent studies concerning medicinal plants unveiled the truth that herbals can be a prolific source of antibacterial activities. […] The application of phytomedicines to treat drug-resistant bacterial infections has considerably increased worldwide in recent years. […] Manuka honey has been suggested to be effective against MRSA because of its bactericidal activity. […] Penicillin was initially used for the treatment of S. aureus infections. […] Vancomycin has been used for over 50 years to treat MRSA bacteremia. […] The recently launched drug linezolid helps to treat MRSA infections and other drug-resistant bacterial infections.

• #73 Can you get rid of MRSA completely?

  https://www.medicinenet.com/can_you_get_rid_of_mrsa_completely/article.htm

  An individual may get rid of MRSA completely by following the prescription given by doctors. […] Yes, an individual may get rid of MRSA completely by following the prescription given by doctors strictly. MRSA can be treated with powerful antibiotics, nose ointments, and other therapies. […] Incision and drainage remain the primary treatment option for MRSA related skin infections. Additional treatment with antibiotics may depend on clinical assessment. Vancomycin or daptomycin are the agents of choice for the treatment of invasive MRSA infections. […] Vancomycin is considered to be one of the powerful antibiotics which is usually used in treating MRSA. However, this drug is slow on acting on bacteria. Some bacteria may also get resistant to this drug. […] As per research, a combo of three drugs or antibiotics may kill deadly staph infections. These antibiotics include meropenem, piperacillin, and tazobactam. These are from a class of antibiotics called beta-lactams that are not effective if given individually, however a combination of these three drugs is said to destroy MRSA.

• #74 How Light Turns Hydrogen Peroxide into a MRSA Treatment | The Brink | Boston University

  https://www.bu.edu/articles/2019/blue-light-therapy-mrsa-treatment/

  Boston University engineers have invented a new blue light therapy that can kill MRSA without antibiotics. Their technique, which they are preparing to take into a clinical trial, uses phototherapy and hydrogen peroxide to kill 99.9 percent of antibiotic-resistant bacteria. Boston University College of Engineering researchers who invented the technique say they have shown, experimentally, it can kill 99.9 percent of methicillin-resistant Staphylococcus aureus, known as MRSA. When hydrogen peroxide is delivered in combination with blue light, it’s able to flood the insides of MRSA cells and cause them to biologically implode, eradicating 99.9 percent of bacteria. Perhaps what’s most promising is that blue light phototherapy doesn’t affect healthy cells of the body, so the technique could be used to treat MRSA infections without harming any surrounding tissue or skin. Partnering with Purdue University microbiologists and researchers at the Massachusetts General Hospital Wellman Center for Photomedicine, the group analyzed the therapy’s effectiveness in mice and observed that the blue light plus hydrogen peroxide treatment was able to speed healing of skin wounds infected with MRSA. Now, Cheng’s lab is teaming up with David Negron, a foot surgeon at Boston Medical Center and instructor of surgery at BU School of Medicine, to develop a clinical trial evaluating the technique’s ability to treat patients with diabetic ulcers. If we can treat diabetic ulcers, that will change people’s lives, Cheng says.

• #75 Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review

  https://www.mdpi.com/2079-6382/11/5/606

  MRSA infections can resist the effects of numerous common antibiotics; hence, it is more intricate to treat. […] The world health organization (WHO) has listed MRSA as a “priority pathogen” due to its successful clones and ability to spread life-threatening diseases. […] The Public Health Agency of Canada (PHAC) has regarded MRSA as one of the priority antimicrobial-resistant pathogens. […] Recent studies concerning medicinal plants unveiled the truth that herbals can be a prolific source of antibacterial activities. […] The application of phytomedicines to treat drug-resistant bacterial infections has considerably increased worldwide in recent years. […] Manuka honey has been suggested to be effective against MRSA because of its bactericidal activity. […] Penicillin was initially used for the treatment of S. aureus infections. […] Vancomycin has been used for over 50 years to treat MRSA bacteremia. […] The recently launched drug linezolid helps to treat MRSA infections and other drug-resistant bacterial infections.

• #76 Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review

  https://www.mdpi.com/2079-6382/11/5/606

  Synergistic or combination therapy is a new approach against resistant microorganisms such as MRSA, VRSA, etc. […] The combination of drugs shows better results than the activity of individual medications. Hence, unique and effective drugs against resistant bacteria can be discovered via this method. […] Bacteriophage therapy, or phage therapy, is a cost-effective treatment method that uses viruses to treat bacterial infections. […] The high antibiotic resistance profile of MRSA indicates the need for new interventions such as vaccines and new antibiotics. […] Vancomycin is mainly used to treat MRSA infections, either alone or in combination. […] The combination of antibiotics with NPs can accomplish all the requirements of an effective antibacterial agent and save millions of lives.

• #77 Treatment of MRSA-infected osteomyelitis using bacterial capturing, magnetically targeted composites with microwave-assisted bacterial killing | Nature Communications

  https://www.nature.com/articles/s41467-020-18268-0

  Owing to the poor penetration depth of light, phototherapy, including photothermal and photodynamic therapies, remains severely ineffective in treating deep tissue infections such as methicillin-resistant Staphylococcus aureus (MRSA)-infected osteomyelitis. Here, we report a microwave-excited antibacterial nanocapturer system for treating deep tissue infections that consists of microwave-responsive Fe3O4/CNT and the chemotherapy agent gentamicin (Gent). This system, Fe3O4/CNT/Gent, is proven to efficiently target and eradicate MRSA-infected rabbit tibia osteomyelitis. Its robust antibacterial effectiveness is attributed to the precise bacteria-capturing ability and magnetic targeting of the nanocapturer, as well as the subsequent synergistic effects of precise microwaveocaloric therapy from Fe3O4/CNT and chemotherapy from the effective release of antibiotics in infection sites. The advanced target-nanocapturer of microwave-excited microwaveocaloric-chemotherapy with effective targeting developed in this study makes a major step forward in microwave therapy for deep tissue infections.

• #78 Treatment of MRSA-infected osteomyelitis using bacterial capturing, magnetically targeted composites with microwave-assisted bacterial killing | Nature Communications

  https://www.nature.com/articles/s41467-020-18268-0

  The final nanocomposites (Fe3O4/CNT/Gent) rapidly and efficiently eradicated MRSA-induced osteomyelitis by capturing the bacteria and enabling the MCCT to subsequently kill it in combination with magnetic targeting. This strategy is promising for improving the penetration of microwaveocaloric sensitizers and enhancing bacteria-specific synergistic therapies. […] An active bacteria-targeting nanocapturer with controlled release of antibiotics in particular not only reduces the toxicity of antibiotics but also improves therapeutic effects for bacterial infections. […] The synthesized Fe3O4/CNT/Gent nanocapturers thus had a desirable microwaveocaloric effect and MV stability, making them a promising candidate for MCT. […] The mechanism underlying the broad-spectrum bactericidal action of Fe3O4/CNT/Gent nanocapturer is as follows. First, Fe3O4/CNT/Gent precisely captures the bacteria by anchoring with the amino groups of the bacterial surface, favoring in situ treatment and thus improving the therapeutic efficacy of MCCT. Then, the microwaveocaloric effect of Fe3O4/CNT/Gent effectively damages the bacterial membrane and releases the Gent simultaneously.

• #79 Treatment of MRSA-infected osteomyelitis using bacterial capturing, magnetically targeted composites with microwave-assisted bacterial killing | Nature Communications

  https://www.nature.com/articles/s41467-020-18268-0

  The antibacterial rates of Fe3O4/CNT/Gent for MRSA after heating for 5, 10, 15, and 20min were 6.96%, 47.82%, 72.68%, and 99.72%, respectively. […] The Fe3O4/CNT/Gent nanocapturers demonstrated strong efficacy of MCCT in vitro, as well as excellent biosafety and superior blood circulation, they were investigated for further applications in a rabbit model of osteomyelitis. […] The Fe3O4/CNT/Gent+MV+MF group always demonstrated the greatest antibacterial efficacy against MRSA in vivo.

• #80

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1871

  MRSA stands for methicillin-resistant Staphylococcus aureus. It is a type of bacteria that can cause a staph infection. But it cannot be killed by the antibiotic methicillin and some other antibiotics. This sometimes makes it harder to treat. […] Depending on how serious your infection is, the doctor may drain your wound and you may get antibiotics through a small tube placed in a vein (I.V.). Your doctor may also give you an antibiotic ointment to use on sores or in your nose. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

• #81

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1871

  MRSA stands for methicillin-resistant Staphylococcus aureus. It is a type of bacteria that can cause a staph infection. But it cannot be killed by the antibiotic methicillin and some other antibiotics. This sometimes makes it harder to treat. […] Depending on how serious your infection is, the doctor may drain your wound and you may get antibiotics through a small tube placed in a vein (I.V.). Your doctor may also give you an antibiotic ointment to use on sores or in your nose. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

• #82 Staphylococcus Aureus Infection Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/971358-treatment

  Treatment guidelines have been published. […] A randomized, double-blind study by Thwaites et al that included 758 patients with S aureus bacteremia assigned adjunctive rifampicin or a placebo, reported no overall benefit in adjunctive rifampicin over standard antibiotic therapy. […] Appropriately monitor renal function, CBC count, and serum hepatic transaminase levels while patients with Staphylococcus aureus infection are undergoing therapy. […] Impetigo and other minor skin infections (ie, superficial or localized infections) may be treated with a topical agent such as mupirocin or retapamulin. […] However, most CA-MRSA strains are or readily become resistant to mupirocin. […] More extensive or serious skin disease and bullous impetigo are treated with oral antistaphylococcal agents, as noted above.

• #83 Learning about MRSA: A guide for Patients – MN Dept. of Health

  https://www.health.state.mn.us/diseases/staph/mrsa/book.html

  Don’t do this yourself. It is very dangerous to squeeze or poke a skin infection because it can push the bacteria deeper into the skin and make the infection much worse. Your doctor will open the sore and drain it. After the infection is drained, you must keep it covered with a clean, dry bandage, until it heals. […] To decrease the amount of staph on your body your doctor may, for a short period of time: Tell you to shower daily with antibacterial soap, Prescribe antibiotic ointment to put in your nose for several days, Prescribe antibiotic pills (in some cases). […] Contact your doctor if: you have any new symptoms during or after treatment for a MRSA skin infection such as a new fever or a fever that won’t go away, the infection gets worse, the infection is not healing, the infection comes back, you have questions.

• #84 Staphylococcus aureus | Johns Hopkins ABX Guide

  https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540518/all/Staphylococcus_aureus

  If such patients are not responding well to vancomycin, consider switch to an alternative, e.g, daptomycin or combination therapy. […] MRSA: Preferred: Vancomycin 15-20 mg/kg IV q12h. […] Alternatives: Daptomycin 6-8 mg/kg IV q 24h. […] For patients with serious S. aureus infections treated with vancomycin, trough levels should be 15-20 mcg/ml (20 mcg/ml for CNS infection and severe pneumonia).

• #85

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1871

  Call your doctor or nurse advice line now or seek immediate medical care if: You have worse symptoms of infection, such as: Increased pain, swelling, warmth, or redness. Red streaks leading from the area. Pus draining from the area. A fever. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You do not get better as expected.

• #86 MRSA: What It Is, Causes, Symptoms & Treatment – Southern Iowa Mental Health Center

  https://simhcottumwa.org/mrsa-what-it-is-causes-symptoms-treatment/

  MRSA can sometimes lead to a serious condition called sepsis, or even death, according to the CDC. […] StatPearls notes that MRSA death rates range between 5% and 60%, and are higher among older adults, people with other medical problems, and those in nursing homes. […] Taking all your antibiotic medications as prescribed by your doctor is key when you’re living with MRSA, according to the CDC. […] It also recommends that you and your housemates follow all the MRSA precautions to help stop the spread of this difficult-to-treat infection while you heal.

• #87 MRSA: What It Is, Causes, Symptoms & Treatment – Southern Iowa Mental Health Center

  https://simhcottumwa.org/mrsa-what-it-is-causes-symptoms-treatment/

  MRSA can sometimes lead to a serious condition called sepsis, or even death, according to the CDC. […] StatPearls notes that MRSA death rates range between 5% and 60%, and are higher among older adults, people with other medical problems, and those in nursing homes. […] Taking all your antibiotic medications as prescribed by your doctor is key when you’re living with MRSA, according to the CDC. […] It also recommends that you and your housemates follow all the MRSA precautions to help stop the spread of this difficult-to-treat infection while you heal.

• #88 Methicillin-resistant Staphylococcus aureus – Wikipedia

  https://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

  In skin infections and secondary infection sites, topical mupirocin is used successfully. For bacteremia and endocarditis, vancomycin or daptomycin is considered. For children with MRSA-infected bone or joints, treatment is individualized and long-term. Neonates can develop neonatal pustulosis as a result of topical infection with MRSA. Clindamycin is not approved for the treatment of MRSA infection, but it is still used in children for soft-tissue infections. […] Evaluation for the replacement of a prosthetic valve is considered. Appropriate antibiotic therapy may be administered for up to six weeks. Four to six weeks of antibiotic treatment is often recommended, and is dependent upon the extent of MRSA infection. […] Cleaning the wound of dead tissue and draining abscesses is the first action to treat the MRSA infection. Administration of antibiotics is not standardized and is adapted by a case-by-case basis. Antibiotic therapy can last up to 3 months and sometimes even longer.

• #89 Methicillin-resistant Staphylococcus aureus – Wikipedia

  https://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

  MRSA infection can occur associated with implants and joint replacements. Recommendations on treatment are based upon the length of time the implant has been in place. In cases of a recent placement of a surgical implant or artificial joint, the device may be retained while antibiotic therapy continues. If the placement of the device has occurred over 3 weeks ago, the device may be removed. Antibiotic therapy is used in each instance sometimes long-term. […] MRSA can infect the central nervous system and form brain abscess, subdural empyema, and spinal epidural abscess. Excision and drainage can be done along with antibiotic treatment. Septic thrombosis of cavernous or dural venous sinus can sometimes be a complication. […] Treatment is not standardized for other instances of MRSA infection in a wide range of tissues. Treatment varies for MRSA infections related to: subperiosteal abscesses, necrotizing pneumonia, cellulitis, pyomyositis, necrotizing fasciitis, mediastinitis, myocardial, perinephric, hepatic, and splenic abscesses, septic thrombophlebitis, and severe ocular infections, including endophthalmitis. Pets can be reservoirs and pass on MRSA to people. In some cases, the infection can be symptomatic and the pet can develop a MRSA infection. Health departments recommend that the pet be taken to the veterinarian if MRSA infections keep occurring in the people who have contact with the pet.

• #90 MRSA: What It Is, Causes, Symptoms & Treatment – Southern Iowa Mental Health Center

  https://simhcottumwa.org/mrsa-what-it-is-causes-symptoms-treatment/

  MRSA can sometimes lead to a serious condition called sepsis, or even death, according to the CDC. […] StatPearls notes that MRSA death rates range between 5% and 60%, and are higher among older adults, people with other medical problems, and those in nursing homes. […] Taking all your antibiotic medications as prescribed by your doctor is key when you’re living with MRSA, according to the CDC. […] It also recommends that you and your housemates follow all the MRSA precautions to help stop the spread of this difficult-to-treat infection while you heal.

• #91 MRSA: Causes, Symptoms, Diagnosis, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/11633-methicillin-resistant-staphylococcus-aureus-mrsa

  MRSA infections are hard to treat because very few antibiotics are effective against them. […] Providers treat MRSA infections by caring for open wounds and finding antibiotics that are effective against the strain of MRSA you have. Wound treatment includes draining fluid and surgically removing infected tissue. […] Antibiotics a provider might use to treat MRSA include: Vancomycin, Rifampin, Trimethoprim/sulfamethoxazole (TMP/SMX), Ceftaroline, Linezolid, Daptomycin, Clindamycin, Doxycycline, Delafloxacin. […] Sometimes, MRSA is called a superbug because its defense mechanisms against so many antibiotics make it hard to treat. One strategy providers might use is to treat you with more than one type of antibiotic at a time. […] If you have a skin infection, your provider will surgically treat and drain your wounds. They might give you topical or oral antibiotics. You’ll need to be treated in the hospital if you have a severe or invasive MRSA infection. […] Yes, more than half of all MRSA cases are cured with antibiotics, and providers successfully treat most MRSA skin infections. But serious infections like pneumonia, endocarditis and bacteremia can quickly get worse before a provider can find a treatment that works.

• #92 IDSA Guidelines for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections (MRSA) in Adults and Children

  https://www.idsociety.org/practice-guideline/mrsa/

  Evidence-based guidelines for the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). The guidelines are intended for use by health care providers who care for adult and pediatric patients with MRSA infections. The guidelines discuss the management of a variety of clinical syndromes associated with MRSA disease, including skin and soft tissue infections (SSTI), bacteremia and endocarditis, pneumonia, bone and joint infections, and central nervous system (CNS) infections. Recommendations are provided regarding vancomycin dosing and monitoring, management of infections due to MRSA strains with reduced susceptibility to vancomycin, and vancomycin treatment failures.

• #93 Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review

  https://www.mdpi.com/2079-6382/11/5/606

  Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review […] Staphylococcus aureus (S. aureus) is a Gram-positive bacterium that may cause life-threatening diseases and some minor infections in living organisms. However, it shows notorious effects when it becomes resistant to antibiotics. […] Successful MRSA infection management involves rapid identification of the infected site, culture and susceptibility tests, evidence-based treatment, and appropriate preventive protocols. This review describes the clinical management of MRSA pathogenesis, recent developments in rapid diagnosis, and antimicrobial treatment choices for MRSA. […] The antibiotic penicillin was discovered in 1928 by Sir Alexander Fleming. […] The semisynthetic antibiotic methicillin was designed in 1950s, and methicillin-resistant S. aureus (MRSA) was clinically detected in 1960s. […] The emergence of methicillin-resistant strains of staphylococci is because of the acquirement and inclusion of the mobile genetic elements into the chromosomes of the vulnerable strains.

• #94 Methicillin-Resistant Staphylococcus aureus Infections in Patients With Renal Disorders: A Review | Singh | World Journal of Nephrology and Urology

  https://wjnu.org/index.php/wjnu/article/view/384/328

  Daptomycin, a lipopeptide, is an alternative first-line treatment for MRSA infections but is not recommended in pneumonia. […] The current available treatments reduce mortality associated with Staphylococcus aureus infections but fail to prevent complications associated with SAB. […] Therefore, to decrease the bulging infection rate, enforcing preventive measures are necessary. […] The identification and synthesis of new drugs with novel modes of action that may circumvent the developed antibiotic resistance for existing antibiotics are challenging. […] But to overcome the increasing incidence and mortality in cases of MRSA, discovery of new drugs has become a necessity. […] Current management strategies for the treatment of renal disorders with staphylococcus infections are becoming increasingly limited due to the rising incidence of resistant pathogens such as MRSA.

• #95 Methicillin-Resistant Staphylococcus aureus Infections in Patients With Renal Disorders: A Review | Singh | World Journal of Nephrology and Urology

  https://wjnu.org/index.php/wjnu/article/view/384/328

  To prevent resistance to monotherapy, combination therapy of available antibiotics is being explored. […] Hence, there is an urgent need to develop new antimicrobial agents with established renal safety to combat increasing multidrug-resistant MRSA infections, thereby decreasing the associated mortality and morbidity in infected renal patients.

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