New guidelines to help control MRSA drawn up
Mike Wyndham Medical Library
Glycopeptides or linezolid are recommended for MRSA skin and soft tissue infections with high bacteraemia risk |
Updated guidelines for the control of methicillin-resistant Staphylococcus
aureus (MRSA) have been drawn up by a joint working party of the British Society for Antimicrobial Chemotherapy, the Hospital Infection Society and Infection Control Nurses Association.
The guidelines now include recommendations on a number of antibiotics
launched since the previous set of guidelines were
published in 1998, including teicoplanin (Targocid), quinupristin/dalfopristin
(Synercid) and linezolid (Zyvox). They
recommend that, in skin and soft tissue infections, the use of glycopeptides
or linezolid should be considered where the risk of
bacteraemia is high and that intravenous
glycopeptides or linezolid be used in severe intravenous site infection.
The guidelines also recommend the use of either glycopeptides or linezolid
for pneumonic infections where MRSA is the causative agent.
The working party’s previous guidelines focused on prevention and
control of MRSA infections. The new guidelines also look at prophylaxis
and treatment of MRSA infections. Laboratory diagnosis and susceptibility
testing are also covered.
For surgical site prophylaxis, the guidelines recommend that patients
who require surgery (and have a history of MRSA colonisation or infection
without documented eradication) should receive glycopeptide prophylaxis
alone, or in combination with other antibiotics, and that the use of
aminoglycosides should be reassessed in patients not expected to have
MRSA colonisation.
Hayley Wickens, senior microbiology pharmacist at St Mary’s Hospital,
London, commented: “This is an extensive and welcome review of
the evidence for effective prophylaxis and treatment of MRSA infection.
The guidelines highlight the need for further research in areas such
as decolonisation regimens and use of older oral agents in combination
treatment of MRSA infections. Hospital pharmacists will want to discuss
the document with their microbiology and infection control
colleagues, particularly as it will have an
impact on prescribing guidelines within their trusts.”
The guidelines, which have been produced at the request of the Department
of Health’s Special Advisory Committee on Antimicrobial Resistance,
are due to be published in the April issue of the Journal of Antimicrobial
Chemotherapy. |
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