Attempts to eradicate methicillin-resistant Staphylococcus aureus colonization with the use of trimethoprim-sulfamethoxazole, rifampin, and bacitracin

Am J Infect Control. 1988 Aug;16(4):141-6. doi: 10.1016/0196-6553(88)90024-7.

Abstract

Retrospective review of 197 patients with methicillin-resistant Staphylococcus aureus (MRSA) identified 47 in whom a regimen for eradication of MRSA colonization could be evaluated. The patients were elderly (mean age, 67.7 years), with 53% transferred from another institution and 53% treated in an intensive care unit. A mean of 47.1 days of hospitalization with an average of 4.9 antibiotics preceded the first MRSA culture. The usual regimen (mean, 6.0 days) was oral trimethoprim-sulfamethoxazole, 160/800 mg twice daily, oral rifampin, 600 mg once daily, and bacitracin ointment three times a day. Eradication succeeded in 40 patients, 9 relapsed, and MRSA persisted in 7. Twenty-four of 25 nares sites were cleared but only 16 of 22 other sites. MRSA infection eventually developed in 36%. No adverse reactions to the eradication regimen were noted. Although this treatment for MRSA carriage was safe and effective, decreased efficacy outside the nares and relapse limited its value.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Bacitracin / therapeutic use*
  • Carrier State / drug therapy
  • Cross Infection / prevention & control*
  • Drug Combinations / therapeutic use
  • Drug Therapy, Combination / therapeutic use
  • Hospital Bed Capacity, 300 to 499
  • Humans
  • Methicillin / pharmacology
  • Middle Aged
  • Nebraska
  • Penicillin Resistance
  • Retrospective Studies
  • Rifampin / therapeutic use*
  • Staphylococcal Infections / drug therapy*
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / isolation & purification
  • Sulfamethoxazole / therapeutic use*
  • Trimethoprim / therapeutic use*
  • Trimethoprim, Sulfamethoxazole Drug Combination

Substances

  • Drug Combinations
  • Bacitracin
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Trimethoprim
  • Sulfamethoxazole
  • Methicillin
  • Rifampin