Management and control strategies for community-associated methicillin-resistant Staphylococcus aureus

Abstract

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is now a common cause of skin and soft tissue infections and has been implicated in some cases of severe pneumonia and necrotising fasciitis in both children and adults. Objective: This review summarises the available evidence on the management and therapeutic options for the treatment of CA-MRSA, including antibiotic options for both mild and severe disease and prevention and decolonisation strategies. Methods: An extensive Medline literature search was performed to identify relevant articles and selected conference abstracts were incorporated. Results/conclusion: The optimal therapy for CA-MRSA infections has not been fully elucidated. Incision and drainage of purulent lesions and good follow-up wound care are important; adjuvant antibiotic therapy should be considered on the basis of location and extent of disease, systemic symptoms and host risk factors for complicated disease. Patients with severe disease (such as pneumonia and necrotising fasciitis) may require intensive care unit (ICU) care. CA-MRSA is usually susceptible to a variety of oral non-β-lactam antibiotics, such as trimethoprim/sulfamethoxazole, clindamycin, tetracyclines and linezolid. Parenteral therapy with vancomycin or daptomycin can also be considered.

Keywords::

• CA-MRSA
• clindamycin
• community-associated methicillin-resistant Staphylococcus aureus
• community-associated MRSA
• daptomycin
• doxycycline
• fluoroquinolones
• linezolid
• minocycline
• MRSA
• Panton–Valentine leucocidin
• rifampin
• tetracyclines
• tigecycline
• trimethoprim/sulfamethoxazole
• vancomycin