Bacteremia Battle: How Long to Treat MSSA or MRSA?

Patients with MRSA or MSSA should always be treated for at least 2 weeks with IV antibiotics.

Advances in environmental sanitation, immunizations, antimicrobial therapy, and medical research have greatly reduced the impact of infectious diseases (IDs)on our communities. Nonetheless infections and the cost of treating them remain a burden to the health care system.

In primary care practice, we may spend more time making referrals for suspected ID than actually treating infected patients. Here, as a brush up, is the second in our series of 10 practical ID pearls.

2. How long should you treat bacteremia associated with Staphylococcus aureus (methicillin-sensitive S aureus [MSSA] or methicillin-resistant S aureus [MRSA])?

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Answer: Patients with MSSA or MRSA bacteremia should always be treated for at least 2 weeks with IV antibiotics.

Mortality rates associated with MSSA and MRSA bacteremia are up to 80% in untreated patients and as high as 30% with treatment.The most serious complications of S aureus bacteremia include endocarditis, osteomyelitis, and pulmonary septic emboli. Age has been shown to be a very important predictor of mortality; thus, the elderly population is of special concern.1

1. Fu CM, Tseng WP, Chiang WC, et al. Occult Staphylococcus aureus bacteremia in adult emergency department patients: rare but important. Clin Infect Dis. 2012;54:1536-1544.

Click here for Practical ID Pearl #1