Methicillin-resistant Staphylococcus aureus is a frequent cause of hospital-associated infections, including central catheter–associated bacteremia. Vancomycin has been the drug of choice for treating this type of bacteremia for decades in patients who have no contraindications to the antibiotic. However, resistance to vancomycin is an emerging problem. Newer antibiotics approved by the Food and Drug Administration have activity against methicillin-resistant S aureus. Some of the antibiotics also have activity against strains of S aureus that are intermediately susceptible or resistant to vancomycin. This article uses a case study to highlight the clinical signs of vancomycin failure and describes the indications for and appropriate use of alternative antimicrobials such as ceftaroline, daptomycin, linezolid, tigecycline, and telavancin. (Critical Care Nurse. 2016;36[4]:46–57)
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1 August 2016
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August 01 2016
Treating Central Catheter–Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin
Shannon Holt, PharmD, BCPS-AQ ID;
Shannon Holt, PharmD, BCPS-AQ ID
Shannon Holt is an assistant professor of clinical education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and a clinical pharmacist specialist in infectious diseases, Wake Med Health and Hospitals, Raleigh, North Carolina.
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Kelly A. Thompson-Brazill, DNP, ACNP-BC, CCRN-CSC;
Kelly Thompson-Brazill is a nurse practitioner in cardiothoracic surgery, Wake Med Health and Hospitals, a consulting associate instructor, Duke University School of Nursing, Durham, North Carolina, and a contributing editor to Critical Care Nurse.
Corresponding author: Kelly A. Thompson-Brazill, dnp, acnp-bc, ccrn-csc, fccm, Wake Med Heart and Vascular, 3000 New Bern Ave, Suite 1100, Raleigh, NC 27610 (e-mail: [email protected]).
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E. Ryan Sparks, PharmD;
E. Ryan Sparks, PharmD
E. Ryan Sparks is a postgraduate year 1 pharmacy practice resident at Wake Med Health and Hospitals.
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Juliana Lipetzky, PharmD
Juliana Lipetzky, PharmD
Juliana Lipetzky is a postgraduate year 1 pharmacy practice resident at Durham VA Medical Center, Durham, North Carolina.
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Crit Care Nurse (2016) 36 (4): 46–57.
Citation
Shannon Holt, Kelly A. Thompson-Brazill, E. Ryan Sparks, Juliana Lipetzky; Treating Central Catheter–Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin. Crit Care Nurse 1 August 2016; 36 (4): 46–57. doi: https://doi.org/10.4037/ccn2016475
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