Table 2.
Antimicrobial Agent | Route | Active for MRSA? | Evidence for Effectiveness |
Comments | ||||
---|---|---|---|---|---|---|---|---|
Animal Studies | Case Report | Case Series | Clinical Trial* | RCT† | ||||
IV, intravenous. | ||||||||
Nafcillin | IV | No | X | X | X | X | X | MSSA drug of choice |
Cefazolin | IV | No | X | X | X | X | X | MSSA drug of choice |
Ceftriaxone | IV | No | X | X | X | X | X | Probably comparable with nafcillin |
Vancomycin | IV | Yes | X | X | X | X | X | MRSA drug of choice |
Teicoplanin‡ | IV | Yes | X | X | X | X | X | Similar to vancomycin |
Linezolid | Oral, IV | Yes | X | X | X | X | ? Comparable with vancomycin | |
Fluoroquinolone§ | Oral, IV | Some¶ | X | X | X | X | X | ? Need for combination Rx especially for MRSA |
Daptomycin | IV | Yes | X | X | X | Limited data | ||
Clindamycin | Oral, IV | Some¶ | X | X | X | X | X | ? Comparable with nafcillin |
Trimethoprim-sulfamethoxazole | Oral, IV | Most strains | X | X | X | X | X | Data mostly for device infections |
Minocycline | Oral | Most strains | X | X | X | Limited data | ||
Tigecycline | IV | Yes | X | X | Insufficient data | |||
Quinupristin-dalfopristin | IV | Most strains | X | X | X | Limited data | ||
Fusidic acid‡ | Oral | Most strains | X | X | X | X | Use in combination therapy only | |
Rifampin | Oral, IV | Yes | X | X | X | X | X | Use in combination therapy only |
Therapeutic trial or prospective case series.
Randomized clinical trial.
Not available in the United States.
Includes ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin, gemifloxacin though potency versus S. aureus may vary.
Usually only community-associated MRSA strains still susceptible.