Dear Colleagues,
Maybe somebody of you could advise me:
When we treat MRSA infection, many authors recommend to use 2
antibiotics simultaneously (like Rif+Fusid or Rif+Ciprofl or
Clind+Doxycycl, etc.). For example - M.Young in his
article "Managing
of infection in the diabetic foot" (DF Journal, 2007, Vol.10, No 1,
p.10) describes such practice in his hospital.
In a very good (IMHO) article about Rifampicin Steffee et al
(Clinical
use of rifampicin during routine reporting of rifampicin
susceptibilities: a lesson in selective reporting of antimicrobial
susceptibility data. / J. Antimicrob. Chemotherapy, Oct 1997; v. 40,
p. 595 - 598.
http://jac.oxfordjournals.org/cgi/reprint/40/4/595 )
write about high risk of resistance developement after Rif
monotherapy.
I've read the same about fusidic acid.
As I understand, Vancomicin and Linezolid have lower potential for
resistance.
So my question is:
If we use not Vanco or Linez but cheeper drugs (Rif, Fusid, Cipro,
Doxycycl, Clind) and have culture results with antibiotic
succeptibility data of this MRSA isolate - may we use monotherapy?
Are there any publications / guidelines about number of antibiotics
necessary in such cases?
SY,
Oleg.