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
- MRSA colonization treatment: The recommended treatment is not explicitly stated for colonization, but for MRSA skin and skin structure infections, linezolid and vancomycin have been used with cure rates of 79% and 73%, respectively 1.
- Key points:
- Linezolid and vancomycin have been studied for the treatment of MRSA infections.
- Cure rates for MRSA skin and skin structure infections were 79% for linezolid and 73% for vancomycin.
- There is no direct information on the treatment of MRSA colonization.
From the Research
The recommended treatment for MRSA colonization is a combination of intranasal mupirocin 2% ointment and daily chlorhexidine gluconate (2-4%) body washes for 5-7 days, as this regimen has been shown to be effective in eradicating MRSA colonization and reducing the risk of subsequent infection and transmission to others. This treatment approach is supported by the most recent and highest quality study, which found that initial MRSA clearance was more readily achieved with systemic decolonization, including the use of oral antibiotics such as rifampin and doxycycline, in addition to topical chlorhexidine gluconate and intranasal mupirocin 2. However, it's essential to note that the use of oral antibiotics should be considered on a case-by-case basis, taking into account the severity of colonization, the patient's medical history, and the risk of antibiotic resistance.
Some key points to consider when treating MRSA colonization include:
- The importance of screening patients for MRSA nasal carriage and decolonizing carriers during the preoperative period to reduce the risk of SSI 3
- The use of combination therapy, including topical chlorhexidine gluconate and intranasal mupirocin, to improve the likelihood of eradication 4, 5
- The potential for mupirocin resistance to develop, particularly with prolonged use, and the need for alternative agents such as nasal povidone-iodine or photodynamic therapy 3
- The importance of environmental decontamination, including washing bedding, towels, and clothing in hot water and detergent, and disinfecting frequently touched surfaces, to reduce the risk of transmission to others
Overall, the treatment of MRSA colonization requires a comprehensive approach that takes into account the individual patient's needs and the latest evidence-based guidelines. By using a combination of topical and oral antimicrobials, and emphasizing the importance of environmental decontamination, healthcare providers can help reduce the risk of MRSA infection and transmission, and improve patient outcomes.