MRSA: Antimicrobial Advances of Gram-Positive Skin Infections
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium which causes infections in different parts of the body. In the United States, MRSA accounts for an average of 59 percent of all emergency room admissions for patients with skin and soft tissue infections (SSTI). Although this percentage varies across the country, clearly attention must be given to prevent the spread of MRSA and other gram-positive skin infections.
According to Dr. David A. Talan, MD, Professor of Medicine at UCLA School of Medicine, MRSA is “more of an epidemic than Ebola.” Some simple prevention strategies for patients with recurrent MRSA and SSTIs include:
- Avoiding sharing personal hygiene items
- Applying 2% mupirocin ointment to the anterior nares with a sterile cotton applicator twice a day for five days
- Applying 4% chlorhexidrine gluconate solution with the hands or with a clean washcloth to all body parts, excluding the face, open wounds, and mucous membranes, followed by a thorough rinse with water every day for five days
Unfortunately, these simple strategies are often not enough to hold back the progression or recurrence of many gram-positive skin infections. This session from OMedLive covers additional options in greater detail.
Do Antibiotics Improve Abscess Cure Rates?
Dr. Talan discusses a test conducted on stable children with Incised and Drained (I&D) abscesses. They were given either Trimethorprim/Sulfmethoxazole (TMP/SMX) or a placebo. He goes on to share additional results from a test of 190 stable adults using the same criteria. Outcomes achieved were in line with following the 2014 ISDA Guidelines for the Diagnosis and Treatment of SSTI.
Dr. Talan was a principal investigator in a separate randomized, double-blind trial of TMP/SMX vs. placebo for patients with an incised and drained cutaneous abscess. Conclusions drawn from this study are examined by Dr. Talan and Dr. Miller as part of this CME course.
New Gram-Positive Antibiotics
Dr. Loren G. Miller, Professor of Medicine at the David Geffen School of Medicine at UCLA shares several “non-inferiority design” trials for newer gram + antibiotics. The medicines he discusses are Dalbavancin (which has a long elimination half-life and does not require dosage adjustments in patients with renal failure), Oritovancin (showing to be effective against C. difficile as well as some VRE), Tedizolid (having no drug interaction with adrenergic, dopaminergic, or SSRI medications), and Ceftaroline (a 4th generation cephalosporin that has been used as salvage treatment for MRSA bacteremia.
The presentation concludes with defined approaches for managing patients with less severe skin and skin structure infections (SSSIs) as outpatients and more severe SSSIs as inpatients.
To learn more in-depth information about the clinical trials mentioned above, please view CME offering “New Kids on the Block: Antimicrobial Advances in the Management of Gram-Positive Skin Infections” presented on IDCARELIVE.
Disclaimer: All IDCARELIVE articles, reports, summaries, and recaps of events are for informational purposes. The quotes and opinions of the speakers covered are not to be taken as direct advice for individual patients. Patients should always seek care from qualified, properly accredited healthcare professionals.
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