Home' Australian Pharmacist : Australian Pharmacist Oct 2013 Contents Australian Pharmacist October 2013 I © Pharmaceutical Society of Australia Ltd.
Antibiotic therapy for Methicillin resistant
staphylococcus aureus (MRSA) infections
By Hanan Khalil
The purpose of this evidence summary is
to provide the best available evidence for
the efficacy of antibiotics therapy for MRSA
infections in patients with surgical wounds.
For the full review, please refer to Gurusamy
KS, Koti R, Toon CD,Wilson P, Davidson BR.
Antibiotic therapy for the treatment of
methicillin-resistant Staphylococcus aureus
(MRSA) infections in surgical wounds.
Cochrane Database of Systematic Reviews
2013, Issue 8. Art. No.: CD009726.DOI:
aureus (MRSA) infections incidences
represent up to a total of 33% of
infections in certain types of surgical
procedures. Causes for MRSA
infections include; emergency surgery,
contaminated surgery, immune-
suppression, presence of co-morbidities
such as diabetes and surgical procedures
including implants and prosthesis.2
Patients with MRSA infections are
associated with a high incidence of
mortality which could reach up to 12% in
some cases. Various types of antibiotics
are being used in clinical practice for
MRSA infections with variable results.3
This summary will examine the efficacy
of some of those antibiotics in patients
treated with MRSA infections with
Characteristics of the studies
The studies selected for the systematic
review mentioned above were
randomised controlled trials and cluster
Quality of the research
Studies included in the report were of
low methodological quality. The authors
stated that it was difficult to obtain high
methodological quality studies with
adequate randomisation and low bias
due to the unethical nature of the study.
Hence very few randomised controlled
trials were included in the review.
• The following databases were
searched; The Cochrane Wounds
Group Specialised Register, The
Cochrane Central Register of Controlled
Trials, The Database of Abstracts
of Reviews of Effects (DARE), NHS
Economic Evaluation Database,
Health Technology Assessment (HTA)
Database, Ovid MEDLINE, Ovid EMBASE
and EBSCO CINAHL.
• The review only included one trial with
59 participants with MRSA at surgical
• The primary outcomes assessed were;
all cause mortality, serious adverse
events defined as any event that is life-
threatening and quality of life.
• Seconary outcomes included;
total length of hospital stay, use of
healthcare resources (e.g. hospital
visits), eradication of MRSA and time to
complete wound healing.
• The study included thirty participants
randomised to linezolid (600mg
either intravenously or orally every
12 hours for seven to 14 days) and 29
to vancomycin (1 g intravenously every
12 hours for seven to 14 days).
Dr Hanan Khalil is the Director of the
Centre for Chronic Disease Management, a
collaborating centre of the Joanna Briggs
Institute, Faculty of Medicine, Nursing and
Health Sciences, Monash University, and
a reviewer for the consumer group of the
• The study only reported one outcome
which was the eradication of MRSA.
• The number of patients in whom
MRSA was eradicated was statistically
significantly higher in the linezolid
group than in the vancomycin group
(RR 1.80; 95% CI 1.20 to 2.68).
Implications for research and
There is not enough large trials
addressing the above topic and more
research is needed to include trials with
a broad range of outcomes such as
mortality, morbidity, adverse events and,
quality of life.
The review only included one trial
with high risk of bias and suggested
that linezolid was significantly better
in eradicating MRSA than vancomycin
in patients with surgical wound MRSA
1. Gurusamy KS, Koti R, Toon CD,Wilson P, Davidson BR.
Antibiotic therapy for the treatment of methicillin-resistant
Staphylococcus aureus (MRSA) infections in surgical wounds.
Cochrane Database of Systematic Reviews 2013, Issue 8. Art.
No.: CD009726.DOI: 10.1002/14651858.CD009726.pub2.
2. Fraser S, Brady R, Graham C, Paterson-Brown S, Gibb A.
Methicillin-resistant Staphylococcus aureus in surgical patients:
identification of high-risk populations for the development of
targeted screening programmes. Annals of the Royal College
of Surgeons of England 2010;92(4):311–5.
3. Chemaly RF, Hachem RY, Husni RN, Bahna B, Rjaili GA, Waked
A, et al.Characteristics and outcomes of methicillin resistant
Staphylococcus aureus surgical-site infections in patients with
cancer: a case-control study. Annals of Surgical Oncology
Links Archive Australian Pharmacist Sept 2013 Australian Pharmacist Nov 2013 Navigation Previous Page Next Page