(These are notes taken at the New England Dermatological Society meeting of 12/3/11)
PDF of Guidelines: Download MRSA Guidelines
MRSA Guidelines:
Talk BU Dept of Dermatology
December 3, 2011
Kalpana Gupta and Carol Sulis
One needs to consider the difference between Hospital Acquired and Community Acquired (CA-MRSA)
80% of CA-MRSA are soft-tissue infections. Usually are pustular
4% of household pets have CA-MRSA, often contracted from owners.
There is a question of how valuable decolonization really is.
If one has a CA-MRSA abscess it is clear that I &D is better than antibiotics.
For CA-MRSA the antibiotic of choice is Bactrim/Septra. Second choice is doxycycline/minocycline and clindamycin is # 3.
Most CA-MRSA are now resistant to erythromycin.
Topical Antibiotics:
50% are now resistant to Bacitracin and Neomycin.
In the outpatient setting, at present, 0% are resistant to mupirocin.
If consider decolonization:
1) Mupirocin + chlorhexidine scrub for 5 = 10 days
2) Bactrim + Rifampin
There is poor data for the value of decolonization.
