aDivision of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
bDivision of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Correspondence to Souha S. Kanj, MD, FACP, FIDSA, FRCP, FESCMID, FECMM, Professor of Medicine, Head, Division of Infectious Diseases, Chairperson, Infection Control Program, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh 1107 2020, Beirut, Postal code: 1103, Lebanon. Tel: +961 1 350000; fax: +961 1 370814; e-mail: [email protected]
Current Opinion in Infectious Diseases: April 2022 - Volume 35 - Issue 2 - p 112-119
doi: 10.1097/QCO.0000000000000800
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Abstract
Purpose of review
Staphylococcus aureus is a pathogen incriminated in skin and soft tissue infections (SSTIs), with methicillin-resistant S. aureus (MRSA) becoming the predominant cause and representing a significant burden to the healthcare system. The last updated Infectious Diseases Society of America (IDSA) guidelines concerning MRSA infections and SSTIs management were published in 2011 and 2014, respectively. The UK updated guidelines for MRSA infection treatment were published in 2021. Older treatment options may be associated with toxicity and require frequent dosing. There is a paucity of recent reviews on the armamentarium of new agents for MRSA SSTIs treatment.
Recent findings
Since 2005, several new antibiotics received a fast-track approval by the Food and Drug Administration (FDA) for SSTI treatment. These drugs include delafloxacin, omadacycline, tedizolid, ceftaroline, dalbavancin, oritavancin and telavancin. In this manuscript, we will review the data that led to these new drugs approval and discuss their advantages and disadvantages in MRSA SSTIs management.
Summary
MRSA is a major cause of SSTIs. Several novel therapies covering MRSA were FDA-approved for SSTIs. However, the current IDSA guidelines for MRSA infection and SSTIs as well as the recently published UK guidelines on MRSA treatment only consider these drugs as alternative choices or do not mention them at all.
Doctors diagnose MRSA by checking a tissue sample or nasal secretions for signs of drug-resistant bacteria. The sample is sent to a lab where it's placed in a dish of nutrients that encourage bacterial growth.
But because it takes about 48 hours for the bacteria to grow, newer tests that can detect staph DNA in a matter of hours are now becoming more widely available.
Treatment
Both health care-associated and community-associated strains of MRSA still respond to certain antibiotics.
Doctors may need to perform emergency surgery to drain large boils (abscesses), in addition to giving antibiotics.
In some cases, antibiotics may not be necessary. For example, doctors may drain a small, shallow boil (abscess) caused by MRSA rather than treat the infection with drugs.
Preparing for your appointment
While you may initially consult your family doctor, he or she may refer you to a specialist, depending on which of your organs is affected by the infection. For example, he or she may refer you to a doctor trained in skin conditions (dermatologist) or a doctor trained in heart conditions (cardiologist).
What you can do
Before your appointment, you might want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you've had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
What to expect from your doctor
During your physical exam, your doctor will closely examine any skin cuts you may have. He or she might take a sample of tissue or liquid from the cuts for testing.
By Mayo Clinic Staff
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Nov. 08, 2022
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Show references
- Methicillin-resistant Staphylococcus aureus (MRSA). Centers for Disease Control and Prevention. //www.cdc.gov/mrsa/community/index.html. Accessed Nov. 2, 2020.
- Methicillin-resistant Staphylococcus aureus (MRSA) in adults: Epidemiology. //www.uptodate.com/contents/search. Accessed Nov. 2, 2020.
- Methicillin-resistant Staphylococcus aureus (MRSA) in adults: Treatment. //www.uptodate.com/contents/search. Accessed Nov. 2, 2020.
- AskMayoExpert. Methicillin-resistant Staphylococcus aureus (MRSA). Mayo Clinic; 2020.
- Methicillin-resistant Staphylococcus infections (MRSA and MRSE). Elsevier Point of Care. Elsevier; 2020. //www.clinicalkey.com. Accessed Nov. 2, 2020.
- Ferri FF. Methicillin-resistant Staphylococcus aureus (MRSA). In: Ferri's Clinical Advisor 2021. Elsevier; 2021. //www.clinicalkey.com. Accessed Nov. 2, 2020.
- Harris A. Methicillin-resistant Staphylococcus aureus (MRSA) in adults: Prevention and control. //www.uptodate.com/contents/search. Accessed Nov. 2, 2020.
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