Emerging options for treatment of invasive, multidrug-resistant Staphylococcus aureus infections.

Published

Journal Article (Review)

Limited established treatment options exist for the treatment of serious, invasive infections caused by multidrug-resistant Staphylococcus aureus, most notably nosocomially acquired methicillin-resistant S. aureus (MRSA). Although vancomycin represents the gold standard for therapy of such invasive infections, reports of increasing in vitro resistance to vancomycin, combined with reports of clinical failures (with this and other antistaphylococcal agents), underscore the need for alternative therapies. Older agents with favorable in vitro activity available in both oral and intravenous dose forms include trimethoprim-sulfamethoxazole and clindamycin. Limited clinical data exist to support their routine use as initial therapy in the treatment of invasive disease. However, these and other options (e.g., tetracyclines) are being reexplored in the setting of increasing concern over MRSA acquired in the community setting. Newer treatment options for MRSA include linezolid, quinupristin-dalfopristin, daptomycin, and tigecycline. With the exception of linezolid, these newer agents require intravenous administration. Combination therapy may be considered in select invasive diseases refractory to standard monotherapies. These diseases include infections such as endocarditis, meningitis, and prosthetic device infections. Additional alternatives to vancomycin are under clinical investigation. Those in later stages of development include oritavancin, dalbavancin, telavancin, and ceftobiprole.

Full Text

Duke Authors

Cited Authors

  • Drew, RH

Published Date

  • February 2007

Published In

Volume / Issue

  • 27 / 2

Start / End Page

  • 227 - 249

PubMed ID

  • 17253914

Pubmed Central ID

  • 17253914

International Standard Serial Number (ISSN)

  • 0277-0008

Digital Object Identifier (DOI)

  • 10.1592/phco.27.2.227

Language

  • eng

Conference Location

  • United States