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MRSA Infection (cont.)

MRSA Infection Treatment

Antibiotic therapy is still the mainstay of medical care for MRSA, but antibiotic therapy is complicated by MRSA's antibiotic resistance. Consequently, laboratory determination of MRSA antibiotic resistance and susceptibility is important to establishing effective antibiotic treatment. Definitive antibiotic therapy depends on using those antibiotics shown in microbiological tests (using Kirby-Bauer antibiotic discs on agar plates) to effectively reduce and stop MRSA growth. Once the antibiotic sensitivities of the patient sample are determined, the patient can be treated appropriately. Unfortunately, these tests take time (usually several days) before results are available.

The majority of serious MRSA infections are treated with two or more intravenous antibiotics that, in combination, often still are effective against MRSA (for example, vancomycin, linezolid, rifampin, sulfamethoxazole-trimethoprim, and others). Minor skin infections, however, may respond well to mupirocin (Bactroban). The earlier the appropriate diagnosis and therapy is instituted for MRSA, the better the prognosis.

Drainage of pus is the main surgical treatment of MRSA infections. Items that can serve as sources of infection (tampons, intravenous lines) should be removed. Other foreign bodies present that are likely sources of infection (for example, artificial grafts, artificial heart valves, or pacemakers) may need to be removed if appropriate antibiotic therapy is unsuccessful. Other areas that can harbor MRSA and may need surgical interventions are joint infections, postoperative abscesses, and osteomyelitis. This is not an all-inclusive list; any site that continues to harbor and seed MRSA into the patient and is not adequately treated by antibiotic therapy should be considered for surgical intervention. Drainage of pus needs to be followed by appropriate antibiotic therapy as discussed above.

Unfortunately, patients can still die from MRSA infection, even with appropriate antibiotic therapy, if the infection overwhelms the patient's defense mechanisms (immune system).