Evaluating Empiric MRSA Coverage in Hospitalized Patients: More Than Meets the Eye

Study suggests that meaningful benefit of empiric therapy against MRSA is limited to settings with >30% mortality and >10% MRSA prevalence — but the answer may not be so simple.

For patients at risk for methicillin-resistant Staphylococcus aureus (MRSA) infection, anti-MRSA empiric therapy (Clinical Infectious Diseases Feb 1 2011; 52:e18) is recommended by the Infectious Disease Society of America and the Society of Critical Care Medicine. To quantify the mortality benefits of this practice, Carey et al. performed a systematic review and meta-analysis of 37 studies that included >11,600 patients hospitalized for MRSA infection. The primary outcome was adjusted odds ratio (OR) for mortality in those receiving early active empiric antibiotic therapy.

The pooled adjusted mortality OR for appropriate empiric therapy was 0.64. Analysis by infection type yielded estimated absolute mortality reductions of 0.0% (pneumonia),…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases