TABLE 2.

Drugs currently available for MRSA treatment and their potency, advantages, disadvantages and average treatment costs^a

Drug	Susceptible MIC (µg/mL)	Dosing regimen	Disadvantages	Refs
Vancomycin	≤2	25–30 mg/kg IV load, then 15 mg/kg IV every 8–12 h	Higher doses cause nephrotoxicity, Red Man syndrome; long-term use might develop resistance	[43–45]
Daptomycin	≤1	6–10 mg/kg IV every 24 h	Not active for pneumonia	[43–45]
Ceftaroline	≤1	600 mg IV every 8–12 h	Similar to other ?-lactams, its MIC varies; can lead to autoimmune hemolytic anemia	[43–45]
Dalbavancin	≤0.12	1500 mg IV as single dose	ALT elevations; limited evidence of efficacy against VRSA	[43–45]
Oritavancin	≤0.12	1200 mg IV as single dose	Artificially prolongs coagulation tests (INR, PT, aPTT) for ~48 h after administration: use is contraindicated with heparin IV	[43–45]
Telavancin	≤0.12	10 mg/kg IV every 24 h	Nephrotoxicity (boxed warning); QTc prolongation; interferes with coagulation tests (INR, PT, aPTT, ACT) for ~18 h after administration	[18–21,23–27, 29–31,33,35,36, 39–46]
Tedizolid	≤0.5	200 mg IV/PO daily	Bacteriostatic	[43–45]
Linezolid	≤4	600 mg IV/PO every 12 h	Peripheral and optic neuropathy; reversible myelosuppression; serotonin syndrome because of MAO-mediated drug interactions	[43–45]
Tigecycline	≤0.25	100 mg IV load, then 50 mg IV every 12 h	Bacteriostatic; high protein binding; controversial use in bacteremia because of low serum concentrations with standard dosing; pancreatitis; hepatotoxicity.	[43–45]
Delafloxacin	≤0.25	300 mg every 12 h	Serious adverse reactions, including tendinitis, tendon rupture, peripheral neuropathy, central nervous system effects, and exacerbation of Myasthenia gravis	[23–26]

^aAbbreviations: ACT, activated clotting time; ALT, alanine aminotransferase; aPTT, activated partial thromboplastin time; INR, international normalized ratio; IV, intravenous; MAO, monoamine oxidase inhibitors; PO, per oral; PT, prothrombin time; VRSA, vancomycin-resistant Staphylococcus aureus.