Update on prevalence and treatment of methicillin-resistant Staphylococcus aureus infections.
The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) is characterized by variations (sometimes extreme) by country and geographic region. The conventional association of MRSA with healthcare settings has been upset by the emergence of community-associated MRSA infections in many areas. With this surge in MRSA comes a renewed interest in alternative agents to vancomycin for treatment of MRSA infections, including older drugs, such as clindamycin, doxycycline and trimethoprim- sulfamethoxazole. Newer agents, such as linezolid and daptomycin, are aiming to improve on the poor cure rates found with vancomycin in serious MRSA infections, but definitive studies showing superiority of these drugs are not yet available. Finally, the drug-development pipeline contains a number of agents for the treatment of MRSA infections, including enhanced glycopeptides (dalbavancin, oritavancin and telavancin) and anti-MRSA cephalosporins (ceftobiprole). As MRSA becomes the 'new normal' in many areas, clinicians will have to sort out the proper role of a dozen or more anti-MRSA drugs.
Loffler
Cindy A
CA
University of California, San Francisco Medical Center, 521 Parnassus Ave, C-152, San Francisco, CA 94122, USA. cindy.loffler@ucsf.edu
Macdougall
Conan
C
D000081:Acetamides / Q000627:therapeutic use; D000617:Aminoglycosides / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use; D002981:Clindamycin / Q000494:pharmacology / Q000627:therapeutic use; D017576:Daptomycin / Q000494:pharmacology / Q000627:therapeutic use; D004318:Doxycycline / Q000494:pharmacology; D005493:Folic Acid Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D014943:Global Health; D006020:Glycopeptides / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D000069349:Linezolid; D000077427:Lipoglycopeptides; D008712:Methicillin / Q000494:pharmacology*; D016106:Methicillin Resistance; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D023303:Oxazolidinones / Q000627:therapeutic use; D015995:Prevalence; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013420:Sulfamethoxazole / Q000494:pharmacology / Q000627:therapeutic use; D017334:Teicoplanin / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D000078304:Tigecycline; D014295:Trimethoprim / Q000494:pharmacology / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use / Q000031:analogs & derivatives
D000081:Acetamides; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005493:Folic Acid Antagonists; D006020:Glycopeptides; D000077427:Lipoglycopeptides; D023303:Oxazolidinones; D002981:Clindamycin; C443755:ceftobiprole; D017334:Teicoplanin; D014640:Vancomycin; D000078304:Tigecycline; C469289:dalbavancin; D014295:Trimethoprim; D008911:Minocycline; D000069349:Linezolid; D013420:Sulfamethoxazole; D004318:Doxycycline; D017576:Daptomycin; C100708:oritavancin; D008712:Methicillin; C487637:telavancin