ÎOral antimicrobial therapy is recommended for the treatment of active infection only and is not routinely recommended for decolonization (A-III). An oral agent in combination with rifampin, if susceptible, may be considered for decolonization if infections recur despite above measures (C-III).
ÎIn cases where household or interpersonal transmission is suspected:
> Personal and environmental hygiene measures in the patient and contacts are recommended (A-III).
> Contacts should be evaluated for evidence of S. aureus infection: > Symptomatic contacts should be evaluated and treated (A-III); nasal and topical
> Nasal and topical body decolonization of asymptomatic household contacts may be considered (C-III).
body decolonization strategies may be considered following treatment of active infection (C-III).
ÎThe role of cultures in the management of patients with recurrent SSTI is limited:
> Screening cultures prior to decolonization are NOT routinely recommended if at least one of the prior infections was documented as MRSA (B-III).
> Surveillance cultures following a decolonization regimen are NOT routinely recommended in the absence of an active infection (B-III).
MRSA Infections in Neonates Neonatal pustulosis
ÎFor mild cases with localized disease, topical treatment with mupirocin may be adequate in full-term neonates and young infants (A-III).
ÎFor localized disease in a premature or very low birthweight infant or more extensive disease involving multiple sites in full-term infants, IV vancomycin or clindamycin is recommended at least initially until bacteremia is excluded (A-II).
Neonatal MRSA sepsis
ÎIV vancomycin is recommended, dosing as outlined in the Red Book (A-II).
ÎClindamycin and linezolid are alternatives for non-endovascular infections (B-II).
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