Oral streptogramins in the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections.
OBJECTIVE
Chronic methicillin-resistant Staphylococcus aureus (MRSA) infections in debilitated patients are difficult to treat. We studied the clinical efficacy and safety of an oral streptogramin, pristinamycin, for these patients.


METHODS
Patients were admitted consecutively to receive pristinamycin, usually with doxycycline, for 7-21 days. Fifty-six patients (average age 75 years) from hospital and community were treated for skin, soft tissue, chest and other infections.


RESULTS
The overall clinical response rate was 39 of 53 patients (74%; 95% CI: 60%, 85%) cured or substantially improved, from 53 of 56 (95%) patients clinically and 49 of 56 (87.5%) patients bacteriologically evaluable. Toxic effects comprised gastrointestinal disturbances in eight patients (14%) and one (2%) possible skin rash.


CONCLUSIONS
This study suggests that oral streptogramins may be useful in the management of debilitated patients with MRSA infections.
Dancer
S J
SJ
Department of Microbiology, Vale of Leven District General Hospital, Alexandria G83 0UA, Scotland, UK. Stephanie.dancer@scieh.csa.scot.nhs.uk
Robb
A
A
Crawford
A
A
Morrison
D
D
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001434:Bacteriophage Typing; D002908:Chronic Disease; D016001:Confidence Intervals; D005260:Female; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000187:drug effects / Q000302:isolation & purification; D025361:Streptogramins / Q000008:administration & dosage*
D025361:Streptogramins