When Should MRSA Coverage Be Considered in Empiric Antibiotic Therapy for Community-Acquired Bacterial Pneumonia?

ICU admission, receipt of mechanical ventilation within 24 hours of admission, and receipt of antibiotics within 90 days are all predictors of MRSA in patients with CABP.

Methicillin-resistant Staphylococcus aureus (MRSA) is an uncommon but potentially fatal cause of community-acquired bacterial pneumonia (CABP). While comprising <1% of CABP cases, rates rise during years when circulating influenza and other respiratory viruses cause a high burden of community illness. Infectious Diseases Society of America/American Thoracic Society guidelines offer vague recommendations on when MRSA coverage should be included in empiric antibiotic therapy for CABP, resulting in disproportionately high use of vancomycin.

Rhodes and colleagues analyzed electronic health records from 1823 patients hospitalized with CABP at a large academic hospital from 2014 to 2018, and the data were applied to a machine learning model to obt…

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