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. 2019 Jun 20;11(2):8070. doi: 10.4081/or.2019.8070

Table 2.

Limitations of commonly used anti Methicillin resistant Staphylococcus aureus (MRSA) agents.

Anti MRSA agents Type Limitation
Vancomycin Glycopeptide A progressive increase in minimum inhibitory concentration (MIC)
Variability in tissue penetration due to its strong protein binding property
In order to achieve clinical effectiveness, (AUC/MIC ratio of 400), maintaining high trough levels is nephrotoxic
Daptomycin Lipopeptide Ineffective in patients suffering from pneumonia because of being rendered inactive when coming in contact with pulmonary surfactant
Prone to decrease in susceptibility with increase in MIC of Vancomycin
Tigecycline Glycylcycline Increased risk of mortality
Ineffective in HA-MRSA or patients with pneumonia
Low serum levels due to high protein binding
Linezolid Oxazolidinone Causes bone marrow suppression, lactic acidosis and peripheral and optic neuropathy