An expert panel of the Infectious Diseases Society of America (IDSA) recently published its first set of clinical practice guidelines for the treatment of methicillin-resistant staphylococcus aureus (MRSA). The expert panel, consisting of 13 infectious disease specialists, analyzed five decades of studies before developing the evidence-based guidelines.
A central concept of these guidelines is that antibiotics are not always necessary when treating MRSA. The IDSA recommends incision and drainage as treatment for a simple abscess resulting from community-associated MRSA.
According to the guidelines, an antibiotic should only be prescribed after such treatment if the patient:
- Has severe or extensive MRSA disease, or a rapid progression in the presence of associated cellulitis
- Has signs and symptoms of systemic illness
- Has associated comorbidities or immunosupression, such as diabetes
- Is either very young or very old
- Has an abscess in an area that is difficult to drain, such as the face or hands
- Has associated septic phlebitis
- Does not respond to incision or drainage alone
The guidelines were created to help answer the many questions physicians have regarding the treatment of simple and complex cases of MRSA.
They discuss the management of a variety of clinical syndromes associated with MRSA, including skin and soft tissue infections, bacteremia and endocarditis, pneumonia, bone and joint infections, and central nervous system infections.
MRSA accounts for approximately 60 percent of all skin infections seen in emergency departments. Invasive MRSA, which is less common but more serious, is responsible for an estimated 18,000 deaths each year.