Antibiotic therapy for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in non surgical wounds

Gurusamy, Kurinchi Selvan; Koti, Rahul; Toon, Clare D; Wilson, Peter; Davidson, Brian R

doi:10.1002/14651858.cd010427.pub2

Cited by 26 publications

(20 citation statements)

References 105 publications

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“…Amongst antimicrobials for which in vitro testing has shown susceptibility of a particular isolate, the choice will be based on clinical characteristics. No single drug has been shown to be better than another in a Cochrane review on antibiotic treatment of MRSA wounds in humans . If the initial laboratory report includes susceptibilities to drugs that are available and licensed for the species, these should be considered first.…”

Section: Therapeutic Considerations For Mrs Infectionsmentioning

confidence: 99%

Recommendations for approaches to meticillin‐resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.

Morris

Loeffler

Davis

et al. 2017

Veterinary Dermatology

122

154

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Background Multiple drug resistance (MDR) in staphylococci, including resistance to the semi‐synthetic penicillinase‐resistant penicillins such as meticillin, is a problem of global proportions that presents serious challenges to the successful treatment of staphylococcal infections of companion animals. Objectives The objective of this document is to provide harmonized recommendations for the diagnosis, prevention and treatment of meticillin‐resistant staphylococcal infections in dogs and cats. Methods The authors served as a Guideline Panel (GP) and reviewed the literature available prior to September 2016. The GP prepared a detailed literature review and made recommendations on selected topics. The World Association of Veterinary Dermatology (WAVD) provided guidance and oversight for this process. A draft of the document was presented at the 8th World Congress of Veterinary Dermatology (May 2016) and was then made available via the World Wide Web to the member organizations of the WAVD for a period of three months. Comments were solicited and posted to the GP electronically. Responses were incorporated by the GP into the final document. Conclusions Adherence to guidelines for the diagnosis, laboratory reporting, judicious therapy (including restriction of use policies for certain antimicrobial drugs), personal hygiene, and environmental cleaning and disinfection may help to mitigate the progressive development and dissemination of MDR staphylococci.

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Section: Therapeutic Considerations For Mrs Infectionsmentioning

confidence: 99%

Recommendations for approaches to meticillin‐resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.

Morris

Loeffler

Davis

et al. 2017

Veterinary Dermatology

122

154

View full text Add to dashboard Cite

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“…There have been numerous meta-analyses to compare the efficacy of the aforementioned agents in MRSA infection. Four meta-analyses are unusual in that they have assessed all possible treatment options [106][107][108][109], although only one study [107] examined all MRSA infection types (as opposed to MRSA cSSTIs). This latter (network metaanalysis) study identified 24 RCTs (17 for cSSTI and 10 for HAP/VAP) comparing one of six antibiotics with vancomycin.…”

Section: Mrsamentioning

confidence: 99%

Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria

et al. 2015

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The antibiotic pipeline continues to diminish and the majority of the public remains unaware of this critical situation. The cause of the decline of antibiotic development is multifactorial and currently most ICUs are confronted with the challenge of multidrug-resistant organisms. Antimicrobial multidrug resistance is expanding all over the world, with extreme and pandrug resistance being increasingly encountered, especially in healthcare-associated infections in large highly specialized hospitals. Antibiotic stewardship for critically ill patients translated into the implementation of specific guidelines, largely promoted by the Surviving Sepsis Campaign, targeted at education to optimize choice, dosage, and duration of antibiotics in order to improve outcomes and reduce the development of resistance. Inappropriate antimicrobial therapy, meaning the selection of an antibiotic to which the causative pathogen is resistant, is a consistent predictor of poor outcomes in septic patients. Therefore, pharmacokinetically/pharmacodynamically optimized dosing regimens should be given to all patients empirically and, once the pathogen and susceptibility are known, local stewardship practices may be employed on the basis of clinical response to redefine an appropriate regimen for the patient. This review will focus on the most severely ill patients, for whom substantial progress in organ support along with diagnostic and therapeutic strategies markedly increased the risk of nosocomial infections.

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“…This Gram‐positive bacterium is likewise well‐known for biofilm formation in diverse infections involving artificial or biological surfaces . Methicillin‐resistant S. aureus (MRSA) is an infamous contributor to the global antibiotic resistance crisis due to its propensity to carry multidrug resistance (MDR) . The prevalence of MRSA in chronic wounds is 7–30% .…”

mentioning

confidence: 99%

“…2,19 Methicillin-resistant S. aureus (MRSA) is an infamous contributor to the global antibiotic resistance crisis due to its propensity to carry multidrug resistance (MDR). 20,21 The prevalence of MRSA in chronic wounds is 7-30%. 21 By forming biofilms in chronic wounds, MRSA can combine targeted MDR with the general antimicrobial tolerance and immune protection of biofilms to create a challenging therapeutic situation.…”

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confidence: 99%

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Cadexomer iodine provides superior efficacy against bacterial wound biofilms in vitro and in vivo

Fitzgerald

Renick

Forrest

et al. 2016

Wound Repair Regeneration

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Examination of clinical samples indicates bacterial biofilms are present in the majority of chronic wounds, and substantial evidence suggests biofilms contribute significantly to delayed healing. Bacteria in biofilms are highly tolerant of antimicrobials, and little data exist to guide the choice of anti-biofilm wound therapy. Cadexomer iodine (CI) was recently reported to have superior efficacy compared to diverse wound dressings against Pseudomonas aeruginosa biofilms in an ex vivo model. In the current study, the strong performance of CI vs. P. aeruginosa biofilm was confirmed using colony and colony drip-flow in vitro wound biofilm models. Similar in vitro efficacy of CI was also demonstrated against mature Staphylococcus aureus biofilms using the same models. Additionally, the rapid kill of mature S. aureus and P. aeruginosa colony biofilms was visualized by confocal microscopy using Live/Dead fluorescent stains. Superior in vitro efficacy of CI vs. staphylococcal biofilms was further demonstrated against methicillin-resistant S. aureus (MRSA) using multiple biofilm models with log reduction, Live/Dead, and metabolic endpoints. Comparator antimicrobial dressings, including silver-based dressings used throughout and other active agents used in individual models, elucidated only limited effects against the mature biofilms. Given the promising in vitro activity, CI was tested in an established mouse model of MRSA wound biofilm. CI had significantly greater impact on MRSA biofilm in mouse wounds than silver dressings or mupirocin based on Gram-stained histology sections and quantitative microbiology from biopsy samples (>4 log reduction in CFU/g vs. 0.7-1.6, p < 0.0001). The superior efficacy for CI in these in vitro and in vivo models suggests CI topical products may represent a better choice to address established bacterial biofilm in chronic wounds.

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Antibiotic therapy for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in non surgical wounds

Cited by 26 publications

References 105 publications

Recommendations for approaches to meticillin‐resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.

Recommendations for approaches to meticillin‐resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.

Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria

Cadexomer iodine provides superior efficacy against bacterial wound biofilms in vitro and in vivo

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