TY - JOUR
T1 - Treatment of non-life-threatening methicillin-resistant Staphylococcus aureus infections with alternative antimicrobial agents
T2 - a 2-year retrospective review
AU - Drekonja, Dimitri M
AU - Traynor, Laura M.
AU - DeCarolis, Douglas D.
AU - Crossley, Kent B
AU - Johnson, James R
PY - 2009/2
Y1 - 2009/2
N2 - The emergence of methicillin-resistant Staphylococcus aureus (MRSA) infections has created a need for additional antimicrobial options. Patients at the Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, who received alternative (nonvancomycin, nonlinezolid) therapy for MRSA infections from January 2004 to December 2005 were identified retrospectively, with sulfamethoxazole/trimethoprim, clindamycin, tetracyclines, and fluoroquinolones assessed as alternative agents. Medical records were reviewed to determine therapeutic outcome and drug tolerance. During 2004 to 2005, 87 subjects received alternative therapy for MRSA infections. Infections included skin/musculoskeletal (n = 74 [85%]) and urinary tract infections (n = 13 [15%]). Thirty-five (40%) subjects received vancomycin initially, and then an alternative agent, whereas 52 (60%) received only alternative therapy. Treatment succeeded clinically in 77 (89%; 95% confidence interval, 78-96%) subjects. Adverse events were uncommon (6 subjects) and minor, necessitating a change of therapy in only 4 subjects. Alternative agents can be used successfully to treat non-life-threatening MRSA infections in appropriate patients. Randomized comparative trials are needed.
AB - The emergence of methicillin-resistant Staphylococcus aureus (MRSA) infections has created a need for additional antimicrobial options. Patients at the Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, who received alternative (nonvancomycin, nonlinezolid) therapy for MRSA infections from January 2004 to December 2005 were identified retrospectively, with sulfamethoxazole/trimethoprim, clindamycin, tetracyclines, and fluoroquinolones assessed as alternative agents. Medical records were reviewed to determine therapeutic outcome and drug tolerance. During 2004 to 2005, 87 subjects received alternative therapy for MRSA infections. Infections included skin/musculoskeletal (n = 74 [85%]) and urinary tract infections (n = 13 [15%]). Thirty-five (40%) subjects received vancomycin initially, and then an alternative agent, whereas 52 (60%) received only alternative therapy. Treatment succeeded clinically in 77 (89%; 95% confidence interval, 78-96%) subjects. Adverse events were uncommon (6 subjects) and minor, necessitating a change of therapy in only 4 subjects. Alternative agents can be used successfully to treat non-life-threatening MRSA infections in appropriate patients. Randomized comparative trials are needed.
KW - Antimicrobial resistance
KW - Antimicrobial therapy
KW - Methicillin-resistant Staphylococcus aureus
KW - Tetracycline
KW - Trimethoprim/sulfamethoxazole
UR - http://www.scopus.com/inward/record.url?scp=58149481479&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58149481479&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2008.10.001
DO - 10.1016/j.diagmicrobio.2008.10.001
M3 - Article
C2 - 19026510
AN - SCOPUS:58149481479
SN - 0732-8893
VL - 63
SP - 201
EP - 207
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 2
ER -