Treatments and limitations for methicillin-resistant Staphylococcus aureus: A review of current literature

Table 1 Methicillin-resistant S. aureus treatment recommendations[6]

Infections		Antibiotic Treatment
Skin and soft tissue infections (SSTIs)
Uncomplicated SSTIs	Clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), a tetracycline (doxycycline or minocycline) (A-II), linezolid
Complicated SSTIs	IV Vancomycin, Linezolid (oral or IV 600 mg twice daily), Daptomycin (4 mg/kg/dose IV once daily), Telavancin (10 mg/kg/dose IV once daily), Clindamycin (600 mg IV or PO 3 times a day)
Recurrent SSTIs	Nasal decolonization - mupirocin twice daily +/- topical body decolonization - skin antiseptic solution (e.g. chlorhexidine) or dilute bleach baths.
Bacteraemia and infective endocarditis
Native valve endocarditis	Vancomycin; Daptomycin (6 mg/kg/dose IV once daily)
Prosthetic valve endocarditis	Vancomycin + Rifampin (300 mg PO/IV every 8 hour) followed by Gentamicin (1 mg/kg/dose IV every 8 hour)
Pneumonia
Community acquired, or healthcare associated	IV vancomycin or linezolid (600 mg PO/IV twice daily) or clindamycin (600 mg PO/IV 3 times daily)
Bone and joint infections
Osteomyelitis or Septic arthritis	Vancomycin; Daptomycin (6 mg/kg/dose IV once daily); TMP-SMX [4 mg/kg/dose (TMP component) twice daily] + Rifampin (600 mg once daily)
Device-related osteo-articular infections (early onset < 2 mo - prosthetic joint infections)	Vancomycin or Daptomycin (6 mg/kg/dose IV once daily) + Rifampin (600 mg once daily) followed by; Rifampin + fluoroquinolone / TMP- SMX / tetracycline / clindamycin
Device-related osteo-articular infections (early onset < 2 mo - spinal implant infections)	Initial parenteral therapy + Rifampin followed by prolonged oral therapy
CNS infections
Meningitis, Brain abscess, subdural empyema, spinal epidural abscess, Septic Thrombosis of Cavernous or Dural Venous Sinus	IV Vancomycin +/- Rifampin; OR; Linezolid 600 mg PO/IV twice daily or TMP-SMX 5 mg/kg/dose IV every 8-12 hour

SSTIs: Skin and soft tissue infections; TMP-SMX: Trimethoprim-sulfamethoxazole; PO: Per oral; IV: Intravenous; CNS: Central nervous system.