Vancomycin Monotherapy vs Alternative Antibiotics for MRSA Patients: A Systematic Review

Abstract

Background: MRSA (Methicillin-resistant Staphylococcus Aureus) has become a global epidemic at a high rate. MRSA is one of the most difficult infections to treat because of its resistance to several antibiotics. Nowadays, there are still many antibiotics for MRSA in the world. This study discusses antibiotic usage against MRSA infection. It expects to contribute to the third SDG in terms of infection therapy. Method: Seven studies used for this systematic review study were conducted through PubMed and ClinicalTrials.gov databases. Aims: This study compared MRSA patients treated with vancomycin monotherapy and alternative antibiotics. Result: The highest use alternative antibiotics besides vancomycin were linezolid with 27.8%, cotrimoxazole 8.1%, daptomycin was 6.7%, and combination vancomycin plus flucloxacillin was 3.2%. Treatment duration for MRSA, treated using vancomycin compared with alternative antibiotics, did not show a significant difference. Patients treated using vancomycin mostly had higher mortality than the alternative antibiotics. The most dominant age infected by MRSA is the elderly population. Gender dominated by males 59.4% (range from 32.5% to 71.4%). The main comorbidity of the patients was heart disease, diabetes mellitus, and lung disease. Conclusion: Alternative antibiotics mostly have lower mortality compared to vancomycin. Insignificant treatment duration appears between vancomycin and alternative antibiotics. Most patients with MRSA were elderly, male, and patients with comorbid heart disease, diabetes mellitus, and lung disease.