From the Research
For treating MRSA urinary tract infections with oral antibiotics, linezolid 600mg twice daily for 10-14 days is a preferred option, as suggested by the most recent and highest quality study 1.
Treatment Options
- Trimethoprim-sulfamethoxazole (TMP-SMX) is an alternative, typically dosed at 1-2 double-strength tablets (160mg/800mg) twice daily for 7-14 days depending on infection severity.
- Nitrofurantoin 100mg four times daily for 7 days can be used for uncomplicated lower UTIs if the organism is susceptible.
- Doxycycline 100mg twice daily for 7-14 days is another option.
- Fosfomycin 3g single dose may be used for uncomplicated lower UTIs if the organism is susceptible.
Considerations
- Treatment choice should be guided by susceptibility testing, as MRSA resistance patterns vary 2.
- Patients should complete the full course of antibiotics even if symptoms improve quickly, drink plenty of fluids, and follow up if symptoms worsen or don't improve within 48-72 hours.
- The most recent study 1 suggests that linezolid could be a potential first-line drug against MRSA bacteremia, which may also be applicable to urinary tract infections.
Mechanism
- These recommendations target MRSA's altered penicillin-binding proteins that render beta-lactams ineffective, requiring alternative antibiotic mechanisms to treat these resistant infections 3.