From the Guidelines
For treating MRSA skin infections, the most effective antibiotics include vancomycin, trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, doxycycline, and linezolid, with the choice of antibiotic depending on the severity of the infection and patient-specific factors 1. When considering treatment options for MRSA skin infections, it's essential to prioritize antibiotics that have demonstrated efficacy against this resistant bacterium.
Key Considerations
- Vancomycin is often reserved for severe infections due to its intravenous administration and potential side effects, but it remains a crucial option for complicated cases 1.
- Oral antibiotics such as TMP-SMX, clindamycin, doxycycline, and linezolid are effective for less severe infections, with dosages and treatment durations varying based on the specific antibiotic and infection severity 1.
- Incision and drainage of abscesses are critical components of treatment, alongside antibiotic therapy, to ensure the infection is fully addressed 1.
- The mechanism of action of these recommended antibiotics differs from that of beta-lactam antibiotics, which are ineffective against MRSA due to the bacterium's altered penicillin-binding proteins 1.
Treatment Options
- Vancomycin: 15-20 mg/kg every 8-12 hours intravenously for severe infections 1.
- TMP-SMX: 1-2 double-strength tablets twice daily for 7-14 days for less severe infections 1.
- Clindamycin: 300-450 mg three times daily for 7-14 days, with caution due to the potential for Clostridium difficile-associated disease 1.
- Doxycycline or minocycline: 100 mg twice daily for 7-14 days, noting that tetracyclines are not recommended for children under 8 years of age and are pregnancy category D 1.
- Linezolid: 600 mg twice daily for 7-14 days, recognizing it as a more expensive option compared to others 1. It's crucial for patients to complete the full course of antibiotics as prescribed, even if symptoms improve, and to practice good hygiene, including wound care and hand washing, to prevent the spread of MRSA 1.
From the FDA Drug Label
The cure rates in microbiologically evaluable patients with MRSA skin and skin structure infection were 26/33 (79%) for linezolid-treated patients and 24/33 (73%) for vancomycin-treated patients
- Linezolid and vancomycin are antibiotics that have been shown to be effective in treating MRSA skin infections, with cure rates of 79% and 73%, respectively 2.
- The antibiotic linezolid is effective against MRSA skin infections, with a cure rate of 79% in microbiologically evaluable patients 2.
- Vancomycin is also effective against MRSA skin infections, with a cure rate of 73% in microbiologically evaluable patients 2.
From the Research
Antibiotics for MRSA Skin Infections
- The following antibiotics can be used to treat MRSA skin infections:
Considerations for Antibiotic Choice
- The choice of antibiotic should be based on factors such as the severity of the infection, the patient's medical history, and the local resistance patterns of MRSA strains 5, 4
- Incision and drainage may be necessary in addition to antibiotic treatment for some MRSA skin infections 7
- The cost of treatment is also an important consideration, with some antibiotics such as linezolid and daptomycin being more expensive than others like TMP-SMX 5, 6