From the Guidelines
Treatment for MRSA abscesses typically involves incision and drainage as the primary intervention, followed by appropriate antibiotic therapy, with the choice of antibiotic depending on the severity of the infection and the patient's overall health status, as recommended by the Infectious Diseases Society of America 1. The primary treatment for MRSA abscesses is incision and drainage, which is considered the most effective way to manage the infection, especially for small abscesses (less than 5 cm) 1.
- For simple abscesses or boils, incision and drainage alone is likely to be adequate, but additional data are needed to further define the role of antibiotics, if any, in this setting 1.
- Antibiotic therapy is recommended for abscesses associated with severe or extensive disease, rapid progression, signs and symptoms of systemic illness, associated comorbidities or immunosuppression, extremes of age, abscess in an area difficult to drain, associated septic phlebitis, and lack of response to incision and drainage alone 1. Some key points to consider when treating MRSA abscesses include:
- The use of oral antibiotics such as clindamycin, trimethoprim-sulfamethoxazole, doxycycline, and linezolid, which have been shown to be effective against MRSA 1.
- The importance of wound care after drainage, including keeping the area clean, changing dressings regularly, and completing the full course of antibiotics even if symptoms improve 1.
- The need for individualized treatment based on the patient's clinical response and the severity of the infection, as well as the potential need for intravenous antibiotics such as vancomycin, linezolid, or daptomycin for severe infections or those not responding to oral antibiotics 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
- Treatment for MRSA abscess:
- Linezolid (PO) may be effective, with a cure rate of 79% in microbiologically evaluable patients with MRSA skin and skin structure infection.
- Vancomycin (IV) may also be effective, with a cure rate of 73% in microbiologically evaluable patients with MRSA skin and skin structure infection.
- Daptomycin (IV) may be considered for the treatment of MRSA bacteremia, but its effectiveness for MRSA abscess is not directly stated in the provided drug label 2. It is essential to consult a healthcare professional for proper diagnosis and treatment of MRSA abscess, as the choice of antibiotic and treatment regimen may depend on various factors, including the severity of the infection, patient's medical history, and local antibiotic resistance patterns. 3
From the Research
Treatment Options for MRSA Abscess
- Incision and drainage is a primary treatment for MRSA abscess, with antibiotic therapy used in some cases 4, 5, 6, 7, 8
- Oral antibiotic options for uncomplicated community-acquired MRSA (CA-MRSA) include:
- Clindamycin
- Doxycycline
- Trimethoprim-sulfamethoxazole (TMP-SMX)
- Minocycline, which is reliably effective when doxycycline or TMP-SMX fails 4
- In areas where community-acquired MRSA isolates are prevalent, uncomplicated skin and soft-tissue infections (SSTIs) in healthy individuals may be treated empirically with clindamycin, trimethoprim-sulfamethoxazole, or long-acting tetracyclines 7
- For complicated SSTIs requiring hospitalization or intravenous therapy, vancomycin is the drug of choice, with linezolid, daptomycin, and tigecycline also being effective options 7
- Some studies suggest that antibiotics may be unnecessary after surgical drainage of uncomplicated skin and soft tissue abscesses caused by community strains of MRSA, with clinical cure rates being high even without antibiotic treatment 8
Antibiotic Resistance and Susceptibility
- MRSA is resistant to cloxacillin and cephalosporins, but almost all Canadian strains are susceptible to vancomycin and linezolid 6
- MRSA strains are variably susceptible to trimethoprim-sulfamethoxazole (TMP-SMX), tetra/doxycycline, and clindamycin, with pooled Canadian clindamycin resistance being just over 40% 6