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Is it time to replace vancomycin in the treatment of methicillin-resistant Staphylococcus aureus infections?

Publication ,  Journal Article
van Hal, SJ; Fowler, VG
Published in: Clin Infect Dis
June 2013

For more than 4 decades, vancomycin has been the antibiotic of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections. Recently, infections due to isolates with high but susceptible vancomycin minimum inhibitory concentrations have been associated with additional treatment failures and patient mortality. These poorer outcomes may in part be explained by the inability of attaining appropriate vancomycin levels in these patients. However, assumptions that these poor outcomes are solely due to failure to achieve optimal serum levels of vancomycin are premature. The availability of effective alternatives further erodes the position of vancomycin as first-line therapy. The emergence of resistance and cost considerations, however, favor a more measured approach when using alternative antimicrobials. Collectively, the current available data suggest that the optimal therapy for MRSA infections remains unclear. In the absence of further data, the Infectious Diseases Society of America guidelines remain relevant and inform clinicians of best practice for treating patients with MRSA infections.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

June 2013

Volume

56

Issue

12

Start / End Page

1779 / 1788

Location

United States

Related Subject Headings

  • Vancomycin Resistance
  • Vancomycin
  • Treatment Outcome
  • Staphylococcal Infections
  • Microbiology
  • Microbial Sensitivity Tests
  • Methicillin-Resistant Staphylococcus aureus
  • Humans
  • Anti-Bacterial Agents
  • 3202 Clinical sciences
 

Citation

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van Hal, S. J., & Fowler, V. G. (2013). Is it time to replace vancomycin in the treatment of methicillin-resistant Staphylococcus aureus infections? Clin Infect Dis, 56(12), 1779–1788. https://doi.org/10.1093/cid/cit178
Hal, Sebastiaan J. van, and Vance G. Fowler. “Is it time to replace vancomycin in the treatment of methicillin-resistant Staphylococcus aureus infections?Clin Infect Dis 56, no. 12 (June 2013): 1779–88. https://doi.org/10.1093/cid/cit178.
van Hal, Sebastiaan J., and Vance G. Fowler. “Is it time to replace vancomycin in the treatment of methicillin-resistant Staphylococcus aureus infections?Clin Infect Dis, vol. 56, no. 12, June 2013, pp. 1779–88. Pubmed, doi:10.1093/cid/cit178.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

June 2013

Volume

56

Issue

12

Start / End Page

1779 / 1788

Location

United States

Related Subject Headings

  • Vancomycin Resistance
  • Vancomycin
  • Treatment Outcome
  • Staphylococcal Infections
  • Microbiology
  • Microbial Sensitivity Tests
  • Methicillin-Resistant Staphylococcus aureus
  • Humans
  • Anti-Bacterial Agents
  • 3202 Clinical sciences