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đ˛đ˛ Antibiotics: Methicillin-Resistant Staphylococcus Aureus (MRSA) - #MEDSHED
đ¨ MRSA in the blood stream is an independent predictor of mortality. Methicillin-resistant staphylcoccus aureus (MRSA) has a become a common pathogen in the community, and known as a nosocomial organism looking for high risk patients.
đ¨ Oral options are available IV and their difference in drug classes provides alternatives for true allergies. These include sulfamethoxazole-trimethoprim, doxycycline, linezolid, and clindamycin. Oral vancomycin is indicated only for Clostridium difficile.
đ¨ Keep in mind safety pearls. Bactrim can cause AKI and hyperkalemia.
đ¨ Doxycycline gets you sunburnt, but at least its not renally metabolized.
đ¨ Linezolid develops thrombocytopenia with prolonged use.
đ¨ Clindamycin has limited uses with high resistance and association with C. diff.
đ¨It amazes me how vancomycin remains an effective first-line agent for MRSA. Vancomycin flushing syndrome is the new term, but nephrotoxicity isnât.
đ¨ Daptomycin provides once daily dosing. It does cause rhabdomylosis and is inactivated by lung surfactant.
đ¨ Ceftaroline is the only beta-lactam indicated for MRSA. Its a newer generation than cefepime, but lacks pseudomonas coverage.
đ¨ Ortivancin and dalbavancin are fairly recent, and provide one time dosing for skin infections.
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Not medical advice. Educational purposes only. No relationships to report.
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