Which empiric antibiotics are indicated in patients with bacterial pneumonia and suspected MRSA infection?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

For suspected infection with methicillin-resistant S aureus (MRSA), vancomycin or linezolid may be added to the antibiotic regimen until the organism's identity and antibiotic sensitivities are known, at which point the medications can be adjusted accordingly. Note, however, that when nine studies were combined in a meta-analysis, linezolid was not superior in terms of higher cure rates for MRSA pneumonia when compared with the glycopeptides vancomycin and teicoplanin. [68] In addition, neither vancomycin nor linezolid is an optimal agent for the treatment of methicillin-sensitive S aureus (MSSA). [3]

Other agents that may be considered for use against MRSA include clindamycin, trimethoprim-sulfamethoxazole (TMP-SMZ), gentamicin, ciprofloxacin, and rifampin. More antibiotics are being evaluated for activity against MRSA. [69]


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