Selecting a Treatment Regimen
Table 1. Recommendations for the Treatment of MRSA (cont'd) Manifestation
Treatments
Management/ Surgery
Central Nervous System Infections Meningitis
For CNS shunt infection, shunt removal is recommended, and it should not be replaced until CSF cultures are repeatedly negative (A-II).
Brain abscess, subdural empyema, spinal epidural abscess
Neurosurgical evaluation for incision and drainage is recommended (A-II).
Septic thrombosis of cavernous or dural venous sinus
Surgical evaluation for incision and drainage of contiguous sites of infection or abscess is recommended whenever possible (A-II). The role of anticoagulation is controversial.
Bone and Joint Infections VancomycinठOsteomyelitis
Surgical debridement and drainage of associated soſt tissue abscesses is the mainstay of therapy and should be performed whenever feasible (A-II).
Treat adults for ≥ 8 weeks (A-II); children for 4-6 weeks. If no debridement, continue for 12+ weeks with rifampin plus 2nd
based on sensitivities (C-III).
drug
Daptomycin‡ (Cubicin®
Linezolid (Zyvox®
)
Clindamycin (Cleocin®
others)
and rifampin
8 ,
TMP-SMX‡ (Bactrim®
) ‡ Adjust dose for renal impairment – see Prescribing Information for renal dosing.
15-20 mg/kg/dose IV q8-12h
) 6 mg/kg/day IV daily
600 mg PO/IV bid
600 mg PO/IV tid
3.5-4 mg/kg/dose PO/IV bid
600 mg PO daily Vancomycin‡§
Treat for 2 weeks.
Linezolid (Zyvox®
)
TMP-SMX‡ (Bactrim®
Treat for 4-6 weeks.
Linezolid (Zyvox®
)
TMP-SMX‡ (Bactrim®
Treat for 4-6 weeks.
Linezolid (Zyvox®
)
TMP-SMX‡ (Bactrim®
Vancomycin‡§
15-20 mg/kg/dose IV q8-12h
600 mg PO/IV bid
) 5 mg/kg/dose Vancomycin‡§
600 mg PO/IV bid
PO/IV q8-12h
15-20 mg/kg/dose IV q8-12h
) 5 mg/kg/dose
600 mg PO/IV bid
Duration of Therapy
Agent (Brand)
Antibiotics Adult Dose
PO/IV q8-12h
15-20 mg/kg/dose IV q8-12h
) 5 mg/kg/dose
PO/IV q8-12h
