Avoiding the Perfect Storm: The Biologic and Clinical Case for Re-evaluating the 7-Day Expectation for MRSA Bacteremia Before Switching Therapy.
Clin Infect Dis. 2014 Jul 21;
Authors: Kullar R, McKinnell JA, Sakoulas G
Persistent methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) is associated with poor outcomes and serious complications. The MRSA guidelines define treatment failure and persistent bacteremia as>7 days; however, this definition requires re-evaluation. Aggressively reducing the bacterial inoculum promptly is critical because factors are already in place before clinical presentation that are driving resistance to the few antibiotics that are available to treat MRSAB. Alternative approaches to treat MRSAB should be considered within 3-4 days of persistent MRSAB. With rapid molecular diagnostics emerging in clinical microbiology laboratories and biomarkers as a potential for early patient risk stratification, a future shorter threshold may become possible.
PMID: 25048852 [PubMed - as supplied by publisher]