IDSA Releases MRSA Treatment Guidelines
Perhaps to celebrate the 50th anniversary of MRSA's discovery in 1961, IDSA just released their first MRSA treatment guidelines. The guidelines don't discuss infection prevention strategies but rather focus on specific clinical questions such as "What is the management of skin and soft-tissue infections (SSTIs) in the era of community-associated MRSA (CA-MRSA)?"
A recommendation getting a lot of attention in the press is that you don't always have to treat MRSA with antibiotics. What! We treat viruses and pseudo-infectious syndromes with antibiotics, we should at least give antibiotics to patients with pathogenic bacteria even if they aren't needed. It's only fair! (sarcasm alert) The press attention focuses on the first recommendation in the document that says "For a cutaneous abscess, incision and drainage is the primary treatment (A-II). For simple abscesses or boils, incision and drainage alone is likely to be adequate, but additional data are needed to further define the role of antibiotics, if any, in this setting."
My favorite section deals with "Research Gaps" such as whether vancomycin should be the first drug of choice for empirical therapy or should the patient also receive a β-lactam antibiotic to cover for MSSA? The guidelines also have a "Performance Measures" section that includes weight-based dosing of vancomycin combined with trough-monitoring.
Overall, for an almost 30-page guideline (not counting references), I found it very well written and organized. Nine of 15 authors (if I counted correctly) report COI. The guidelines were endorsed by the Pediatric Infectious Diseases Society, the American College of Emergency Physicians, and the American Academy of Pediatrics.
-Eli
Liu C. et al CID Feb 1, 2011 (full text of Guidelines)
IDSA Press release 1/5/2011
A recommendation getting a lot of attention in the press is that you don't always have to treat MRSA with antibiotics. What! We treat viruses and pseudo-infectious syndromes with antibiotics, we should at least give antibiotics to patients with pathogenic bacteria even if they aren't needed. It's only fair! (sarcasm alert) The press attention focuses on the first recommendation in the document that says "For a cutaneous abscess, incision and drainage is the primary treatment (A-II). For simple abscesses or boils, incision and drainage alone is likely to be adequate, but additional data are needed to further define the role of antibiotics, if any, in this setting."
My favorite section deals with "Research Gaps" such as whether vancomycin should be the first drug of choice for empirical therapy or should the patient also receive a β-lactam antibiotic to cover for MSSA? The guidelines also have a "Performance Measures" section that includes weight-based dosing of vancomycin combined with trough-monitoring.
Overall, for an almost 30-page guideline (not counting references), I found it very well written and organized. Nine of 15 authors (if I counted correctly) report COI. The guidelines were endorsed by the Pediatric Infectious Diseases Society, the American College of Emergency Physicians, and the American Academy of Pediatrics.
-Eli
Liu C. et al CID Feb 1, 2011 (full text of Guidelines)
IDSA Press release 1/5/2011
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