What antibiotics (abx) can be given for a Vancomycin-Resistant Staphylococcus aureus (VRSA) infection in Israel?

From the Guidelines

For a Vancomycin-Resistant Staphylococcus aureus (VRSA) infection in Israel, the recommended antibiotics include quinupristin-dalfopristin, TMP-SMX, linezolid, or telavancin, as these options have been suggested for use when reduced susceptibility to vancomycin is present 1. When considering treatment options for VRSA infections, it's crucial to prioritize antibiotics that have shown efficacy against strains with reduced susceptibility to vancomycin.

• Key considerations include:
  • Quinupristin-dalfopristin 7.5 mg/kg/dose IV every 8 h
  • TMP-SMX 5 mg/kg/dose IV twice daily
  • Linezolid 600 mg PO/IV twice daily
  • Telavancin 10 mg/kg/dose IV once daily These antibiotics can be used as single agents or in combination with other antibiotics, depending on the severity and site of infection, as well as the patient's clinical response 1. Given the rarity and complexity of VRSA infections, infectious disease consultation is strongly recommended to guide treatment decisions and ensure optimal patient outcomes.
• Treatment duration and specific antibiotic choices should be individualized based on factors such as infection site, severity, and patient comorbidities. In the context of Israeli antimicrobial stewardship practices, where VRSA infections are extremely rare, prompt and aggressive management with appropriate antibiotics is essential to minimize morbidity, mortality, and improve quality of life.

From the Research

Treatment Options for Vancomycin-Resistant Staphylococcus aureus (VRSA) Infections

• The following antibiotics have shown effectiveness against VRSA infections:
  • Daptomycin 2
  • Quinupristin/dalfopristin 2
  • Linezolid 2
  • Telavancin 2
• These antibiotics have demonstrated bactericidal activity against VRSA, with telavancin and daptomycin showing concentration-dependent activity 2
• Other antibiotics that may be effective against VRSA infections include:
  • Ceftaroline 3
  • Tigecycline 3
  • Oritavancin 3
  • Dalbavancin 3

Considerations for Treatment

• The choice of antibiotic should be based on the severity of the infection, the patient's medical history, and the susceptibility of the VRSA isolate to the antibiotic 3
• Combination therapy may be considered for severe infections or in cases where the patient has a history of antibiotic resistance 4
• It is essential to monitor the patient's response to treatment and adjust the antibiotic regimen as needed 5

Availability of Antibiotics in Israel

• The availability of these antibiotics in Israel may vary, and it is essential to consult with a healthcare professional to determine the best course of treatment for a VRSA infection in Israel 5, 6, 3, 2, 4