Community-Associated Methicillin-Resistant Staphylococcus Aureus (CA-MRSA)

Background

Risk Factors

  • Multiple skin sites
  • Recurrent infection
  • Close contact of person with Hx of MRSA
  • Infection showing early necrosis

Management

Antibiotic Sensitivities[1]

Category Antibiotic CA-MRSA
Penicillins Penicillin G R
Penicillin V R
Methicillin R
Nafcillin/Oxacillin R
Cloxacillin/Diclox. R
Amino-Penicillins AMP/Amox R
Amox-Clav R
AMP-Sulb R
Anti-Pseudomonal Penicillins Ticarcillin R
Ticar-Clav R
Pip-Tazo R
Piperacillin R
Carbapenems Doripenem R
Ertapenem R
Imipenem R
Meropenem R
Aztreonam R
Fluroquinolones Ciprofloxacin I
Ofloxacin X1
Pefloxacin X1
Levofloxacin I
Moxifloxacin I
Gemifloxacin I
Gatifloxacin I
1st G Cephalo Cefazolin R
2nd G. Cephalo Cefotetan R
Cefoxitin R
Cefuroxime R
3rd/4th G. Cephalo Cefotaxime R
Cefizoxime R
CefTRIAXone R
Ceftaroline S
CefTAZidime R
Cefepime R
Oral 1st G. Cephalo Cefadroxil R
Cephalexin R
Oral 2nd G. Cephalo Cefaclor/Loracarbef R
Cefproxil R
Cefuroxime axetil R
Oral 3rd G. Cephalo Cefixime R
Ceftibuten R
Cefpodox/Cefdinir/Cefditoren R
Aminoglycosides Gentamicin X1
Tobramycin X1
Amikacin X1
Chloramphenicol X1
Clindamycin I
Macrolides Erythromycin I
Azithromycin I
Clarithromycin I
Ketolide Telithromycin I
Tetracyclines Doxycycline S
Minocycline S
Glycylcycline Tigecycline S
Daptomycin S
Glyco/Lipoclycopeptides Vancomycin S
Teicoplanin S
Telavancin S
Fusidic Acid S
Trimethoprim S
TMP-SMX S
Urinary Agents Nitrofurantoin S
Fosfomycin S
Other Rifampin S
Metronidazole R
Quinupristin dalfoppristin S
Linezolid S
Colistimethate R

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

Table Overview

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014

Authors:

Ross Donaldson