Current issues in the management of sinonasal methicillin-resistant Staphylococcus aureus.
OBJECTIVE
Staphylococcus aureus is an important pathogen, contributing to both pediatric and adult infections in the USA. In recent years, methicillin-resistant Staphylococcus aureus (MRSA) has become a source of public fear and outcry. In this article, we review facts and fiction of sinonasal MRSA.


RESULTS
Although the exact role of bacteria in chronic rhinosinusitis continues to be debated, the role of MRSA in these patients is even less apparent. When MRSA is involved, there are few to guide treatment. Oral, parenteral, and topical antibiotics are all used in the treatment of sinonasal MRSA. MRSA eradication has been advocated by some; however, there are few data to support the efficacy of eradication. Current treatment regimens by the authors are reviewed.


CONCLUSIONS
There is much that is not known about the role of MRSA in sinonasal infection, and the impact of sinonasal MRSA on the health quality of the community also remains undefined. Treatment outlines are presented; however, with the current state of data, these treatment preferences lack a solid, evidence-based foundation that is favored. Future studies will lay the foundation for more rigorously supported treatment algorithms.
Becker
Samuel S
SS
Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-8605, USA. sam.s.becker@gmail.com
Russell
Paul T
PT
Duncavage
James A
JA
Creech
C Buddy
CB
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012852:Sinusitis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents