Osteomyelitis And Mrsa

Description: from Medscape Critical Care Osteomyelitis and MRSA? Question What are the antibiotics of choice for treatment of chronic bone infection with methicillin-resistant Staphylococcus aureus (MRSA)? Response from Greg S. Martin, MD Assistant Professor, Medicine, Division of Pulmonary Medicine, Emory University School of Medicine; Director, Emory Pulmonary Clinic, Grady Memorial Hospital, Atlanta, Georgia The treatment for chronic osteomyelitis due to MRSA depends on associated signs, symptoms, and complications. Making the presumption that some form of nonsurgical therapy is appropriate, vancomycin is the drug of choice in most situations. It is highly active against MRSA and has a good adverse-effect profile. However, it is only active when administered intravenously, making it most appropriate for hospitalized patients. Chronic intravenous therapy may be accomplished with the use of an indwelling intravenous catheter, either peripherally or centrally inserted. Recently, new drugs have arrived that permit more flexible administration while still being active against MRSA. The most flexible of these is linezolid,[1,2] which is available for adults in both intravenous and oral formulations and is highly active against Gram-positive pathogens such as MRSA. Quinupristin/dalfopristin[2,3] is an agent with a similar spectrum of activity for Gram-positive pathogens, but is only available in an intravenous formulation. Posted 07/01/2003