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Pharmacotherapy for methicillin-resistant Staphylococcus aureus nosocomial pneumonia.
Segarra-Newnham, Marisel; Church, Timothy J.
Afiliação
  • Segarra-Newnham M; Veterans Affairs Medical Center VAMC, West Palm Beach, FL, USA. marisel.segarra-newnham@va.gov
Ann Pharmacother ; 46(12): 1678-87, 2012 Dec.
Article em En | MEDLINE | ID: mdl-23232021
ABSTRACT

OBJECTIVE:

To review the evidence for pharmacologic agents available in the treatment of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. DATA SOURCES A search of PubMed (1975-July 2012) was conducted using a combination of the terms methicillin-resistant Staphylococcus aureus, pneumonia, nosocomial, vancomycin, linezolid, telavancin, ceftaroline, tigecycline, and quinupristin/dalfopristin. STUDY SELECTION AND DATA EXTRACTION Randomized comparative clinical trials, meta-analyses, and review articles published in English were included. A manual review of the bibliographies of available literature was conducted and all relevant information was included. Observational and in vitro studies were incorporated as indicated. DATA

SYNTHESIS:

Pharmacotherapy for the treatment of nosocomial MRSA pneumonia is limited. Vancomycin has been the treatment of choice for several years. Linezolid has demonstrated similar efficacy to vancomycin in randomized clinical trials and recent data have suggested that it may be superior in some cases, although there are limitations to this conclusion. Telavancin has also demonstrated similar clinical efficacy to vancomycin; however, the drug is not commercially available in the US. Other agents with MRSA activity include ceftaroline, clindamycin, quinupristin/dalfopristin, and tigecycline, although the evidence for their use in nosocomial pneumonia is limited.

CONCLUSIONS:

Based on the currently available evidence and cost-effectiveness, vancomycin should continue to be the drug of choice for most patients with nosocomial MRSA pneumonia. Linezolid is a reasonable alternative for patients with treatment failure while receiving vancomycin, isolates with vancomycin minimum inhibitory concentrations over 2 µg/mL, allergic reactions, or vancomycin-induced nephrotoxicity.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Estafilocócica / Staphylococcus aureus Resistente à Meticilina / Antibacterianos Tipo de estudo: Clinical_trials / Guideline / Systematic_reviews Limite: Humans Idioma: En Revista: Ann Pharmacother Assunto da revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Estafilocócica / Staphylococcus aureus Resistente à Meticilina / Antibacterianos Tipo de estudo: Clinical_trials / Guideline / Systematic_reviews Limite: Humans Idioma: En Revista: Ann Pharmacother Assunto da revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Estados Unidos