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New Clinical Guidelines for MRSA Treatment

Categories: Antimicrobial Resistance, Healthcare-associated infections, MRSA

Catherine Liu, MD

Catherine Liu, MD

Author – Dr. Catherine Liu
Assistant Clinical Professor, Division of Infectious Diseases, University of California

Methicillin-resistant Staphylococcus aureus (MRSA) – both healthcare- and community-associated – has become an enormous public health problem. MRSA is responsible for about 60 percent of skin and soft tissue infections seen in emergency rooms, and invasive MRSA kills about 18,000 people annually. Clinicians often struggle with how best to treat MRSA, resulting in wide variations in approaches to therapy. The growing clinical impact of MRSA, particularly community-acquired infections, prompted the Infectious Diseases Society of America to develop its first treatment guidelines for MRSA. Charged with reviewing the evidence and developing the guidelines, my coauthors and I aimed to create a framework to help clinicians evaluate and treat uncomplicated and invasive MRSA infections. As with all IDSA guidelines, they are voluntary and are not meant to replace clinical judgment, but rather synthesize the available evidence and support the decision-making process, which must be individualized for each patient.

The guidelines address 11 topics commonly encountered by adult and pediatric clinicians. They provide guidance in the management of: skin and soft tissue infections including recurrent infections; use of intravenous vancomycin; and invasive infections, such as pneumonia, and infections in the bones, joints, blood or heart.

In the midst of our battle against drug resistance, IDSA hopes the guidelines highlight the importance of the judicious use of antibiotics. For instance, the bulk of the evidence so far suggests incision and drainage may be adequate for the treatment of simple abscesses or boils. We’re eagerly awaiting the results of two large, NIH-sponsored, randomized trials to further clarify the role of antibiotics in this setting.

The guidelines also call for better drugs to treat MRSA. Although a number of new drugs have been developed and FDA-approved, we have yet to discover the golden bullet.

Of course, additional research is necessary on MRSA and as with all IDSA guidelines, these recommendations will evolve as new information and antibiotics become available.

See the full-text Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections in Adults and Children,” or pick up the Feb. 1 issue of Clinical Infectious Diseases.

Public Comments

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this blog is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

  1. July 9, 2011 at 2:24 am ET  -   Antonio

    The Golden bullet is right in front of us and no one is looking at how simple it is to kill the bacteria. A 470 nm Blue Light, an LED source of light which is safe to the skin and works within minutes. It was discovered in early 2009 and published among the most respectable news lines. So far, we have done all else and nothing with it. It is time we start looking at basics,as we can’t deal with a bacteria that is part of our ecosystem. MRSA was here before us and it is here to stay, it will keep mutating to the newest of antibiotics. Using the Blue Light on a victim will give an antibiotic a chance to kill the bacteria. Thanks for reading.

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  2. April 5, 2011 at 12:04 am ET  -   Ruby Osorio

    Thank you for your valuable post.

    We have decided to share it with our global physician audience at PhysicianNexus.com: http://physiciannexus.com/forum/topics/new-clinical-guidelines-for

    Ruby
    Team Member
    http://www.PhysicianNexus.com
    Physicians connecting worldwide

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  3. March 30, 2011 at 10:04 am ET  -   Aracely lucendo

    I am a Spanish operating room nurse and having read the article, I’m still wondering what the best way is to treat these patients when they come to the operating room. The protocols that the Preventive Medicine Services emit seem successful but the reality is that they are difficult to carry out considering that several professionals (+ or – 7) inside an operating room are involved in the patient’s perioperative process and not all of them are aware of the seriousness of the problem to act in a coordinated way, designed to protect the patient and prevent the spread of infection. It’s very complicated having to control all team members to ensure that the protocol is met. I am very interested in knowing surgical protocols of action with MRSA-infected patients that you have to improve our actions. Thank you very much for your attention.

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  4. March 19, 2011 at 11:14 am ET  -   Isabelle Hilliard

    MRSA stated back in the 70′s from Urinary Tract Infections., and was mostly found in the elder with indwelling foley catheters. The Medical Profession did not know how to treat or recogize the signs or symptoms, but treated with antibiotics for regular infections, Cleanliness is one of the most important methods , also Antibiotics used today must be provided over a longer period of time than years in the past. Many people die when the infection enters the blood stream of elderly infants and children, before the antibiotic can take effect. We need to look at the real cause. It is ok to say one has the disease, but how did they get it. The root of the problem with help identify its orgin and then look at the method of treatment.
    MRSA today comes in many forms. Some Antibiotics does not help, it causes injury to other organs of our body.

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