OBJECTIVE: To discuss community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections and evaluate older antibiotics as suitable therapeutic treatment options. DATA SOURCES: Searches of MEDLINE, EMBASE, and the Cochrane Library (1966-May 2006) were performed using the key terms methicillin resistance, community-acquired, community associated, treatment, Staphylococcus aureus, mec, and Panton-Valentine leukocidin. STUDY SELECTION AND DATA EXTRACTION: All articles were critically evaluated and all relevant information was included in this review. DATA SYNTHESIS: There has been a documented shift of methicillin resistance occurring in staphylococcal infections manifested within the community. Infections caused by CA-MRSA possess unique characteristics including lack of hospital-associated risk factors, improved susceptibility patterns, distinct genotypes, faster doubling times, and additional toxins. Potential therapeutic options to treat these infections include trimethoprim/sulfamethoxazole (TMP/SMX), clindamycin, tetracyclines, fluoroquinolones, and new antimicrobials. CONCLUSIONS: CA-MRSA infections can be successfully treated with older, oral antibiotic agents including TMP/SMX, clindamycin, and tetracyclines. Fluoroquinolones and linezolid should be avoided as first-line agents.
OBJECTIVE: To discuss community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections and evaluate older antibiotics as suitable therapeutic treatment options. DATA SOURCES: Searches of MEDLINE, EMBASE, and the Cochrane Library (1966-May 2006) were performed using the key terms methicillin resistance, community-acquired, community associated, treatment, Staphylococcus aureus, mec, and Panton-Valentine leukocidin. STUDY SELECTION AND DATA EXTRACTION: All articles were critically evaluated and all relevant information was included in this review. DATA SYNTHESIS: There has been a documented shift of methicillin resistance occurring in staphylococcal infections manifested within the community. Infections caused by CA-MRSA possess unique characteristics including lack of hospital-associated risk factors, improved susceptibility patterns, distinct genotypes, faster doubling times, and additional toxins. Potential therapeutic options to treat these infections include trimethoprim/sulfamethoxazole (TMP/SMX), clindamycin, tetracyclines, fluoroquinolones, and new antimicrobials. CONCLUSIONS: CA-MRSA infections can be successfully treated with older, oral antibiotic agents including TMP/SMX, clindamycin, and tetracyclines. Fluoroquinolones and linezolid should be avoided as first-line agents.
Authors: Louis S Green; James M Bullard; Wendy Ribble; Frank Dean; David F Ayers; Urs A Ochsner; Nebojsa Janjic; Thale C Jarvis Journal: Antimicrob Agents Chemother Date: 2008-11-17 Impact factor: 5.191
Authors: Young Kyung Yoon; Eu Suk Kim; Jian Hur; Shinwon Lee; Shin Woo Kim; Jin Won Cheong; Eun Ju Choo; Hong Bin Kim Journal: Infect Chemother Date: 2014-09-24