title: Treating Central Catheter-Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin.
abstract: Methicillin-resistant Staphylococcus aureus is a frequent cause of hospital-associated infections, including central catheter-associated bacteremia. Vancomycin has been the drug of choice for treating this type of bacteremia for decades in patients who have no contraindications to the antibiotic. However, resistance to vancomycin is an emerging problem. Newer antibiotics approved by the Food and Drug Administration have activity against methicillin-resistant S aureus Some of the antibiotics also have activity against strains of S aureus that are intermediately susceptible or resistant to vancomycin. This article uses a case study to highlight the clinical signs of vancomycin failure and describes the indications for and appropriate use of alternative antimicrobials such as ceftaroline, daptomycin, linezolid, tigecycline, and telavancin. (Critical Care Nurse 2016;36[4]:46-57).
authors.affiliation: Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist in infectious diseases, Wake Med Health and Hospitals, Raleigh, North Carolina.Kelly Thompson-Brazill is a nurse practitioner in cardiothoracic surgery, Wake Med Health and Hospitals, a consulting associate instructor, Duke University School of Nursing, Durham, North Carolina, and a contributing editor to Critical Care Nurse.E. Ryan Sparks is a postgraduate year 1 pharmacy practice resident at Wake Med Health and Hospitals.Juliana Lipetzky is a postgraduate year 1 pharmacy practice resident at Durham VA Medical Center, Durham, North Carolina.
authors.forename: Shannon
authors.initials: S
authors.lastname: Holt
authors.affiliation: Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist in infectious diseases, Wake Med Health and Hospitals, Raleigh, North Carolina.Kelly Thompson-Brazill is a nurse practitioner in cardiothoracic surgery, Wake Med Health and Hospitals, a consulting associate instructor, Duke University School of Nursing, Durham, North Carolina, and a contributing editor to Critical Care Nurse.E. Ryan Sparks is a postgraduate year 1 pharmacy practice resident at Wake Med Health and Hospitals.Juliana Lipetzky is a postgraduate year 1 pharmacy practice resident at Durham VA Medical Center, Durham, North Carolina. kthompson-brazill@wakemed.org.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Thompson-Brazill
authors.affiliation: Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist in infectious diseases, Wake Med Health and Hospitals, Raleigh, North Carolina.Kelly Thompson-Brazill is a nurse practitioner in cardiothoracic surgery, Wake Med Health and Hospitals, a consulting associate instructor, Duke University School of Nursing, Durham, North Carolina, and a contributing editor to Critical Care Nurse.E. Ryan Sparks is a postgraduate year 1 pharmacy practice resident at Wake Med Health and Hospitals.Juliana Lipetzky is a postgraduate year 1 pharmacy practice resident at Durham VA Medical Center, Durham, North Carolina.
authors.forename: E Ryan
authors.initials: ER
authors.lastname: Sparks
authors.affiliation: Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist in infectious diseases, Wake Med Health and Hospitals, Raleigh, North Carolina.Kelly Thompson-Brazill is a nurse practitioner in cardiothoracic surgery, Wake Med Health and Hospitals, a consulting associate instructor, Duke University School of Nursing, Durham, North Carolina, and a contributing editor to Critical Care Nurse.E. Ryan Sparks is a postgraduate year 1 pharmacy practice resident at Wake Med Health and Hospitals.Juliana Lipetzky is a postgraduate year 1 pharmacy practice resident at Durham VA Medical Center, Durham, North Carolina.
authors.forename: Juliana
authors.initials: J
authors.lastname: Lipetzky
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D055499:Catheter-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin