Current treatment options for MRSA, skin infections: What you should know

While incision and drainage remain the primary treatment option for methicillin-resistant Staphylococcus aureus and skin infections, additional treatment with antibiotics may be warranted based on clinical assessment. Antibiotic treatment should be guided by the susceptibility profile of the organism, according to the CDC.

Infectious Disease News presents 5 “fast facts” about current treatment options for MRSA and skin infections.

1. Daptomycin is comparable to vancomycin for the treatment of MRSA in patients with impaired renal function.

In a study of 100 patients assigned vancomycin and 50 patients assigned daptomycin (Cubicin, Merck) for the treatment of MRSA bacteremia, 51% of patients in the vancomycin group and 58% of patients in the daptomycin group had a glomerular filtration rate of less than 50 mL/min/1.73 m2. Read more

2. SOLO I trial: Single-dose oritavancin is noninferior to twice-daily vancomycin for bacterial skin infections and MRSA.

Oritavancin (Orbactiv, The Medicines Company) was noninferior to vancomycin in the rate of investigator-assessed clinical cure (79.6% vs. 80%) and in the proportion of patients whose lesions reduced by 20% or more (86.9% vs. 82.9%). Read more

3. Researchers update recommendations for treatment of common skin abscesses associated with MRSA.

According to a review published in The New England Journal of Medicine, skin abscesses have become increasingly common, particularly in association with MRSA infection. Despite new therapeutic options, the success rate is highly variable. The researchers said that needle aspiration may be used as an initial alternative to incision-based drainage, although they cited research that full drainage and symptom resolution at 7 days is achieved in only 26% of patients who underwent needle aspiration vs. an 80% success rate with incision and drainage. Clinicians using needle aspiration should let patients know that further drainage may be needed, according to the review. Read more

4. MRSA treatment protocols vary across countries.

American and European physicians and surgeons treat surgical site infections and MRSA using an array of control procedures that are often not part of standardized protocols. As more research is conducted, health care system administrators can draw on a greater body of evidence in developing treatment protocols. Read more

5. Universal decolonization effectively reduced MRSA rates in the ICU.

In the cluster-randomized REDUCE MRSA trial of 74,256 patients undergoing treatment across 74 ICUs, researchers found that universal decolonization led to a significant hazard reduction of MRSA-positive clinical cultures (HR=0.63) compared with a targeted decolonization group (HR=0.75) and a screening and isolation group (HR=0.92). Read more