title: Vancomycin in the treatment of meticillin-resistant Staphylococcus aureus (MRSA) infection: End of an era?
abstract: Infection with meticillin-resistant Staphylococcus aureus (MRSA) continues to have significant morbidity and mortality. Vancomycin, which has been the mainstay of treatment of invasive MRSA infections, has several drawbacks related to its pharmacological properties as well as varying degrees of emerging resistance. These resistant subpopulations are difficult to detect, making therapy with vancomycin less reliable. The newer agents such as linezolid, daptomycin, ceftaroline, and the newer glycopeptides telavancin and oritavancin are useful alternatives that could potentially replace vancomycin in the treatment of certain conditions. By summarising the discussions that took place at the III MRSA Consensus Conference in relation to the current place of vancomycin in therapy and the potential of the newer agents to replace vancomycin, this review focuses on the challenges faced by the laboratory and by clinicians in the diagnosis and treatment of MRSA infections.
authors.affiliation: Department of Microbiology, University Hospital Crosshouse, NHS Ayrshire and Arran, Kilmarnock, UK. Electronic address: abhijit.bal@nhs.net.
authors.forename: A M
authors.initials: AM
authors.lastname: Bal
authors.affiliation: Infectious Disease Unit, Service of Internal Medicine, Hospital Universitari Mútua de Terrassa, Terrassa, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Garau
authors.affiliation: Department of Medical Microbiology Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: I M
authors.initials: IM
authors.lastname: Gould
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Liao
authors.affiliation: Department of Preclinical and Clinical Pharmacology, University of Florence, Florence, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Mazzei
authors.affiliation: Pathology Queensland Central Laboratory, Brisbane and Griffith University, Gold Coast, Queensland, Australia.
authors.forename: G R
authors.initials: GR
authors.lastname: Nimmo
authors.affiliation: Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Soriano
authors.affiliation: Department of Bio-Medical Science, Section of Microbiology, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Stefani
authors.affiliation: Cepheid, Sunnyvale, CA, USA.
authors.forename: F C
authors.initials: FC
authors.lastname: Tenover
keywords: MIC creep; VISA; hVISA