The IDSA has issued MRSA treatment guidelines. Although the full document is lengthy, here are some of the highlights: Vancomycin is still first line treatment for most patients with invasive MRSA infections. Second line agents include linezolid, daptomycin (but not in pneumonia), and clindamycin. For CA-MRSA skin / soft tissue infections, those with an abscess should be drained (and do not necessarily need antibiotics) while those with purulent cellulitis should be treated with a CA-MRSA agent (TMP-SMX, clindamycin, tetracycline, linezolid). Vancomycin dosing should be 15-20mg/kg for most patients, with trough level goals of 15-20. For patients with an MIC>2, close clinical follow up is recommended, with switching to another agent for treatment failure (Full guidelines).
by Deepak Asudani, MD, MPH, FHM Whether it is the prompt and expeditious international collaboration to develop an Ebola vaccine, or tardy but promising development of the first anti parasitic malarial vaccine or the fascinating technology utilizing synthetic DNA for vaccine development against MERS, these developments promise to highlight significant strides in vaccine development for […]
Economists describe preferences in two ways: revealed and stated. Say, for example, I asked you to implement a penalty program for your team with the goal of decreasing the number of occasions members did not clean their hands after a patient encounter. Because you know bad hands equal bad outcomes, you’re apt to offer up […]
by Eric Howell, MD, SFHM “Tell me what you know about antibiotics.” That’s the discussion I start with hospitalized patients all the time, right after they ask me to prescribe antibiotics for their simple cough, or other viral-like illness. And, from their perspective, asking for antibiotics makes sense. After all, antibiotics have been the physician’s […]