Selecting a Treatment Regimen Table 1. Recommendations for the Treatment of MRSA Treatments Manifestation
Management/ Surgery
Duration of Therapy Skin and Soft Tissue Infections (SSTI)* - Inpatients VancomycinठComplicated SSTI
(patients with deeper soſt tissue infections, surgical/traumatic wound infection, major abscesses, cellulitis, and infected ulcers and burns)
Surgical debridement
Treat for 7-14 days.†
Linezolid (Zyvox®
)
Daptomycin‡ (Cubicin®
)
Telavancin‡ (Vibativ®
)
Clindamycin (Cleocin® others)
, Ceſtaroline fosamil‡ (Teflaro®
Recurrent SSTI Pneumonia
) was FDA approved for ABSSSI in adults caused by various
susceptible pathogens including MRSA aſter the Guidelines were finalized. See Prescribing Information for dosing.
Please see Management of Recurrent MRSA Skin and Soſt Tissue Infections (page 12)
HA-MRSA or CA-MRSA pneumonia
Empiric MRSA therapy is recommended for severe community- acquired pneumonia pending culture results (A-III). Severe = ICU, necrotizing or cavitary infiltrates, or empyema. Empyema requires drainage (A-III).
Vancomycin‡§
Linezolid (Zyvox®
)
Treat for 7-21 days.†
Clindamycin (Cleocin® others)
,
15-20 mg/kg/dose IV q8-12h
600 mg PO/IV bid
600 mg PO/IV tid
15-20 mg/kg/dose IV q8-12h
600 mg PO/IV bid
4 mg/kg/dose IV daily
10 mg/kg/dose IV daily
600 mg PO/IV tid Agent
Antibiotics Adult Dose
NOTE: The use of rifampin as a single agent or as adjunctive therapy for the treatment of SSTI is NOT recommended (A-III). * Cultures from abscesses and other purulent SSTI are recommended in patients treated with antibiotic therapy, those with severe local infection or signs of systemic illness, patients who have not responded adequately to initial treatment, and if there is concern for a cluster or outbreak (A-III).
† Based on the extent of disease and the patient's clinical response.
‡ Adjust dose for renal impairment – see Prescribing Information for renal dosing. § Max: 2 gm/dose. In seriously ill patients consider a loading dose of 25-30 mg/kg (C-III).
4
(cont'd)
(Br
and)
