New treatments for methicillin-resistant Staphylococcus aureus.
OBJECTIVE
Methicillin-resistant Staphylococcus aureus (MRSA) is a dynamic pathogen. Rates of MRSA are increasing worldwide. In some centers, MRSA is becoming less susceptible to vancomycin, and these strains have been associated with worse clinical outcomes. Intermediate or fully resistant vancomycin strains of MRSA have emerged clinically, whereas MRSA acquired in the community has become epidemic. The purpose of this manuscript is to provide clinicians with an evidence-based review on new treatments for MRSA.


RESULTS
Linezolid, daptomycin and tigecycline have been approved during the last decade to treat infections due to MRSA. Although these agents are extremely valuable in the fight against MRSA, each one has limitations. New lypoglycopeptides (telavancin, dalbavancin and oritavancin) are in advanced phase of clinical development. Similarly, new broad-spectrum cephalosporins active against MRSA (e.g. ceftobiprole and ceftaroline) and a new dihydrofolate reductase inhibitor (iclaprim) are in or have completed phase 3 studies.


CONCLUSIONS
Here, we review the most relevant information on new drugs to treat MRSA. New studies with available agents and upcoming studies with investigational drugs will help to better understand the role of each compound in the treatment of patients infected with MRSA and assist the clinician in keeping pace with this challenging pathogen.
Stryjewski
Martin E
ME
Division of Infectious Diseases, Duke Clinical Research Institute, Durham, North Carolina, USA. stryj001@mc.duke.edu
Corey
G Ralph
GR
D000081:Acetamides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017576:Daptomycin / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006020:Glycopeptides / Q000627:therapeutic use; D006801:Humans; D000069349:Linezolid; D055624:Methicillin-Resistant Staphylococcus aureus; D008911:Minocycline / Q000031:analogs & derivatives / Q000627:therapeutic use; D023303:Oxazolidinones / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D000078304:Tigecycline
D000081:Acetamides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D006020:Glycopeptides; D023303:Oxazolidinones; D011743:Pyrimidines; C486448:iclaprim; D000078304:Tigecycline; D008911:Minocycline; D000069349:Linezolid; D017576:Daptomycin