Vancomycin MRSA

Ever since MRSA was identified in 1961, vancomycin has been the drug of choice in the treatment of MRSA infection. However, as vancomycin has been extensively used for treating MRSA infection, some MRSA isolates have developed reduced susceptibility to this drug: these MRSA isolates are termed vancomycin intermediate resistant Staphylococcus. The usual doses of Vancomycin often fail to treat MRSA effectively. And since the MRSA sometimes survives the treatments, the bacteria are becoming resistant to it. So Vancomycin dosing creeps higher and higher to fight the bacteria harder. While the increased dose often successfully treats the infection, but it has a dangerous side effect Vancomycin has been considered to be the reference standard for the treatment of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections, as a result of its relatively clean safety profile, its durability against the development of resistance, and, for many years, the lack of other approved alternatives. However, the advent and testing of new compounds with anti-MRSA activity.

Methicillin-resistant Staphylococcus aureus (MRSA

The use of vancomycin in the treatment of adult patients

The main test for an MRSA infection is a nasal swab. Close to the 2010s, there have been numerous clinical trials suggesting the efficacy of vancomycin for MRSA. Across the board, such trials show that 80% or more of cases may be effectively treated with this antibiotic. Another drug that also is nearly as effective is tigecylcine Most strains of MRSA are inhibited by concentrations of vancomycin ranging from 0.5-2.0 mcg/mL, although strains have been reported with intermediate sensitivity (MIC=8 mcg/mL) that have been called glycopeptide-intermediate Staphylococcus aureus (GISA) or vancomycin-intermediate Staphylococcus aureus (VISA).19 Such infections are likel Time-kill studies have shown that combining cell-wall-active agents, such as β-lactams and vancomycin, with aminoglycosides results in synergy owing to enhanced penetration of the aminoglycoside. 56 Recent studies have demonstrated that gentamicin acts synergistically with vancomycin against MRSA, while rifampicin is antagonistic. 57 The. This document is an executive summary of the new vancomycin consensus guidelines for vancomycin dosing and monitoring. It was developed by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists vancomycin consensus guidelines committee 1.75g/350mL. 2g/400mL. Staphylococcal Enterocolitis. Vancocin and Firvanq. Indicated for enterocolitis caused by Staphylococcus aureus (including methicillin-resistant strains) Firvanq: Indicated for treatment of enterocolitis in adults and pediatric patients <18 years. 0.5-2 g/day PO divided q6-8hr for 7-10 days

Vancomycin ist zu etwa 55% an Plasmaeiweiß gebunden und wird ganz überwiegend unverändert durch die Nieren ausgeschieden. 5 Indikationen. Schwere Infektionen wie z.B. Septikämien, Endokarditiden oder Osteomyelitiden mit MRSA; Therapie der Clostridium-difficile-assoziierte Diarrhö. In diesem Fall wird Vancomycin per os verabreicht. 6. Vancomycin treatment failures have increasingly been reported with infections caused by vancomycin-susceptible MRSA strains with relatively high MICs (ie, 2 μg/mL). 4,5 This observation has prompted a change in the breakpoint for vancomycin susceptibility from 4 to 2 μg/mL for S aureus per CLSI 7 and expert recommendation to administer higher. Since MRSA is a multi resistant staph infection. Most people have not become immune to this antibiotic so this is why it is widely uses. Vancomycin has been the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) cause nosocomial infections and are associated with increased rates of illness and death (1,2).Both organisms are now endemic in many healthcare institutions, particularly in intensive care units (ICUs) ().Vancomycin is commonly used to treat infections caused by MRSA; however, recent emergence of S.

Vancomycin in the Treatment of MRSA: The Bottom Line

From July 8, 2017, through January 31, 2019, we performed a retrospective, multicenter, preimplementation-postimplementation study. Patients with a vancomycin order to treat lower respiratory tract infection (LRTI) underwent MRSA PCR screening; tests were ordered by health care providers, including physicians, physician assistants, and advanced practice registered nurses Vancomycin is an antibiotic medication used to treat a number of bacterial infections. It is recommended intravenously as a treatment for complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, and meningitis caused by methicillin-resistant Staphylococcus aureus. Blood levels may be measured to determine the correct dose screening protocol for methicillin-resistant Staphylococcus aureus (MRSA) on vancomycin therapy duration and on rates of adverse drug events and 30-day hospital readmission. Patients and Methods: From July 8, 2017, through January 31, 2019, we performed a retrospective, multicenter, preimplementation-postimplementation study Vancomycin is a glycopeptide antibiotic administered intravenously for treatment of patients with suspected or proven invasive gram-positive infections, including methicillin-resistant Staphylococcus aureus (MRSA). Appropriate dosing and administration of vancomycin requires consideration of the pathogen and its susceptibility, type and. 8 to 30 days and less than 1200 g: 15 mg/kg IV every 24 hours. 8 to 30 days and 1200 to 2000 g: 10 to 15 mg/kg IV every 8 to 12 hours. 8 to 30 days and greater than 2000 g: 15 to 20 mg/kg IV every 8 hours. 1 month to 18 years: 10 to 13.33 mg/kg IV every 6 to 8 hours. -Maximum dose: 40 mg/kg/day. Uses

Objective: American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines suggest that linezolid (LZD) is preferred over vancomycin (VCM) for treating methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. We conducted a systematic review and comparative meta-analysis to compare VCM and LZD efficacy against proven MRSA pneumonia The infection caused by methicillin-resistant Staphylococcus aureus (MRSA) is a global threat to public health. Vancomycin remains one of the first-line drugs for the treatment of MRSA infections. However, S.aureus isolates with complete resistance to vancomycin have emerged in recent years. Vancomycin-resistant S.aureus (VRSA) is mediated by a vanA gene cluster, which is transferred from. Objective To evaluate whether teicoplanin could be an alternative to vancomycin for treatment of MRSA infection in Chinese population using a meta-analysis in randomized controlled trials. Methods The following databases were searched: Chinese Biomedical Literature database (CBM), Chinese Journal Full-text database (CNKI), Wanfang database, Medline database, Ovid database and Cochrane Library VANCOMYCIN VERSUS DAPTOMYCIN: RETROSPECTIVE DATA EVERYWHERE. Straight out of Detroit, MI. Aside from the initial 2005 clinical trial comparing daptomycin to vancomycin in S. aureus (both methicillin-sensitive [MSSA] and MRSA) BSIs and infective endocarditis, the majority of comparative effectiveness trials have been retrospective and a lot of that data has been from a single geographic.

[Vancomycin photos] KEY POINTS Vancomycin is a glycopeptide antibiotic that inhibits cell wall synthesis in susceptible bacteria by blocking glycopeptide polymerization via binding tightly to the D-alanyl-Dalanine portion of the cell wall precursor Presence of the VanA, VanB, VanC or other Van genes can confer vancomycin resistance via a change in the binding site, where [ Vancomycin is a restricted antibiotic and requires approval for use from the Paediatric Infectious Diseases team. Vancomycin is used for the treatment of serious Gram-positive infections including methicillin-resistant staphylococcus aureus (MRSA) Analysis of the vancomycin-resistant subpopulation of two MRSA isolates (A7 and B7) from the two patients, one isolate (isolate C, Etest vancomycin MIC = 4 μg/mL) of MRSA recovered from a patient with bacteremia in 2000, and Mu3 was performed according to the description by Hiramatsu et al. (1,2).Heteroresistant VISA refers to isolates with vancomycin MICs for one or more subpopulations above. Objectives To investigate the efficacy and safety of Vancomycin Ophthalmic Ointment 1% (Toa Pharmaceutical Co., Ltd, Toyama, Japan) in patients with external ocular infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE). Design A case series. Setting This study was a multicentre, open-label, uncontrolled study in Japan.

The study hypothesis is that the addition of Aurograb to standard vancomycin therapy will improve outcome in MRSA infection. The Primary Objective will be to determine whether the overall response (clinical and bacterial) to Aurograb® (1mg/kg i.v. b.d.) plus vancomycin is greater than the overall response to placebo plus vancomycin, in adult. Monitoring Vancomycin in Serious MRSA Infections. March 24, 2020. Marilyn N. Bulloch PharmD, BCPS, FCCM. The new guidelines recommend dosing vancomycin to achieve an area under the curve to minimum inhibitor concentration (AUC/MIC) ratio of ≥ 400. For the first time in 11 years, an updated consensus guideline on the therapeutic monitoring of. Vancomycin is often called an antibiotic of last resort for MRSA, though resistance against it has been growing. Vancomycin requires IV administration into a vein and can occasionally have severe side effects. Duration of treatment can last weeks to months. Tissue penetration is variable and it has limited penetration into bone

Persistent MRSA Bacteremia and Vancomycin Treatment Failures in Adults A search for and removal of other foci of infection, drainage, or surgical debridement is recommended VANCOMYCIN 1 Vancomycin is a glycopeptide antibiotic with activity against Gram-positive infections such as Staphylococcus including MRSA, Streptococcus and Enterococcus for the treatment of intravascular catheter related blood stream infection, MRSA sepsis, skin and soft tissue infections List H: EPA's Registered Antimicrobial Products Effective Against Methicillin-resistant Staphylococcus aureus (MRSA) and/or Vancomycin Resistant Enterococcus faecalis or faecium (VRE) (pdf) Pesticide Registration Hom Original Article . Investigation of heteroresistant vancomycin intermediate Staphylococcus aureus among MRSA isolates . Deniz Gazel 1, Mehmet Erinmez , Ayşe Büyüktaş Manay1, Yasemin Zer1 . 1 Department of Medical Microbiology, School of Medicine, Gaziantep University, Gaziantep, Turkey . Abstract. Introduction: Heteroresistant vancomycin intermediate Staphylococcus aureus (hVISA) testing. Vancomycin* IV (see nomogram) + Aztreonam 2 g IV q8h 4-6 weeks Approximately 45% of S. aureus at UMHS are MRSA, so initial treatment to cover MRSA is warranted. De-escalate to a beta-lactam if methicillin-susceptible S. aureus (MSSA) is identified. Infectious Diseases Consultation recommended. Daptomycin requires prior approval

Successful treatment of methicillin-resistantVancomycin-resistant Enterococcus - microbewiki

Alternatives to Vancomycin for the Treatment of

Vancomycin is a glycopeptide antibiotic used for the treatment of Gram-positive bacterial infections. Traditionally, it has been used as a drug of last resort; however, clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) strains with decreased susceptibility to vancomycin (vancomycin intermediate-resistant S.aureus [VISA]) and more recently with high-level vancomycin. METHODS Empirical PICU vancomycin indications for suspected CAIs were developed by using epidemiological risk factors for MRSA. We aimed to reduce empirical PICU vancomycin use in CAIs by 30%. After retrospectively testing, the indications were implemented and monthly PICU empirical vancomycin use during baseline (May 2017-April 2018) and postintervention (May 2018-July 2019) periods

How Effective is Vancomycin for MRSA? (with pictures

Proportion of S. aureus, MRSA and VRSA. Among 242 inpatients, S. aureus was isolated from 71 (29.3%) of surgical wound sites. Then, a cefoxitin disk diffusion test, which is a surrogate marker for oxacillin and other penicillinase resistance penicillin, was carried out to determine the proportion of MRSA Compared with patients with MRSA bloodstream infection and vancomycin MIC values less than 1, those patients with MIC values of 1.5 or higher had a greater likelihood of treatment failure, longer.

  1. Since the description in 2002 of the vanA gene cluster in MRSA as the mechanism of high-level vancomycin resistance, 13 isolates have been reported in the United States, 1,2 with others reported.
  2. Mortality was 40% in children with MRSA compared to 4.3% in children without MRSA infection. Twenty-nine of 30 children with MRSA pneumonia received early vancomycin therapy. Of the children with MRSA pneumonia who received vancomycin plus a second MRSA agent within the first 24 hours of hospitalization, mortality was 12.5% (2/16)
  3. with or without risk for MRSA) Clindamycin 600 mg IV q8h Alternative for patients at risk for MRSA non-purulent cellulitis: Vancomycin* IV (see nomogram, AUC goal 400-600) if MRSA coverage is indicated Patients at risk for MRSA: Cellulitis worse on >48 hours of IV βlactam therapy Known MRSA colonization Prior history of MRSA infectio
  4. MRSA. Although vancomycin is the preferred treatment for serious MRSA infection, prolonged, persistent, or recurrent bacteremia during therapy, high rates of microbiological and clinical failures, nephrotoxicity, and increasing prevalence of non-susceptible strains limit vancomycin's effectiveness . New antimicrobial discovery an

Bactericidal agents in the treatment of MRSA infections

Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in the epidemiology of infectious diseases, which causes community- and healthcare-associated MRSA infections with significant morbidity and mortality rates [].Vancomycin has been the antimicrobial of choice for MRSA treatment, but in recent years, the emergence of vancomycin resistance has become a challenging public. Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated pneumonia (HCAP). Vancomycin has been the principal antibiotic for treating such infections; however, growth in use of this drug has given rise to MRSA strains with increased vancomycin minimum inhibitory concentrations (MICs) Vancomycin Resistance This is one of the first reports on this emerging strain of MRSA. USA600 is particularly resistant to vancomycin, which is worrisome because it is the drug we depend on Vancomycin, a tricyclic glycopeptide, is the standard first-line treatment for patients with MRSA bacteremia. However, studies have linked vancomycin treatment failure in MRSA with higher vancomycin MICs even at MICs below the Clinical and Laboratory Standards Institute (CLSI) susceptibility breakpoints for S. aureus (≤2 ug/ml) [8-11]

Sepsis Due to Superinfected Varicella? A Case of a

Therapeutic monitoring of vancomycin for serious

This test is used to monitor levels of the antimicrobial drug vancomycin in the blood. After taking vancomycin, the amount in the blood rises for a period of time, peaks, and then begins to fall, usually reaching its lowest level, or trough, just before the next dose. The next dose is timed to coincide with the falling concentration of the drug in the blood 1. Introduction. Hospital-acquired meningitis remains an important cause of mortality and morbidity. One of the most important causative agents of hospital-acquired meningitis is methicillin-resistant Staphylococcus aureus (MRSA), for which there are limited treatment options , , , , , , , , , , , .Vancomycin is the mainstay of treatment for MRSA meningitis but failures are not rare.

Vancocin (vancomycin) dosing, indications, interactions

  1. of MRSA infections in both the community and healthcare settings, the use of antibiotics active against MRSA also has been on the rise. Among MRSA active antibiotics, vancomycin (VCN) is often considered the antibiotic of choice for patients hospitalized with suspected or documented MRSA infections
  2. Patients with methicillin-resistant S aureus (MRSA) bacteremia and endocarditis may carry a mortality rate of 40%. 1,4 Current guidelines from the Infectious Diseases Society of America (IDSA) recommend empiric MRSA coverage in patients with certain risk factors. 2-6 Even without risk factors, most patients receive empirical vancomycin therapy
  3. To compare the efficacy of systemic treatment with linezolid (LNZ) versus vancomycin (VAN) on methicillin-resistant Staphylococcus aureus (MRSA) burden and eradication in endotracheal tube (ETT) biofilm and ETT cuff from orotracheally intubated patients with MRSA respiratory infection. Prospective observational clinical study was carried out at four European tertiary hospitals
  4. istration (FDA)-approved drugs
  5. Nebulized Vancomycin for Eradication of Persistent MRSA in Patients with Cystic Fibrosis. Persistent MRSA in patients with CF is not easy to prevent or treat, but stringent infection control practices can reduce transmission and optimize outcomes. Share this article via email with one or more people using the form below. To
  6. imum inhibitory concentration (MIC) of vancomycin for<i> S.
  7. The glycopeptide antibiotics, vancomycin and teicoplanin, were the only licensed antibacterial compounds, until recently, to which methicillin-resistant Staphylococcus aureus (S. aureus) clinical.

Vancomycin - DocCheck Flexiko

  1. However, beginning in the early 1980s, physicians and other health-care professionals started to express renewed interest in this drug. This renewed interest was due both to vancomycin's ability to fight methicillin-resistant Staphylococcus aureus (MRSA) and the ability to treat pseudomembranous colitis.Pseudomembranous colitis is a nasty infection of the colon which takes hold after treatment.
  2. ed by the doctor. The usual dose is 40 milligrams per kilogram (mg/kg) of body weight, divided into 3 or 4 doses, and taken for 7.
  3. Although the standard treatment for MRSA bloodstream infections (BSI), vancomycin monotherapy has been tied to treatment failures leading to longer BSI duration and recurrences
  4. g a vancomycin MICBMD of 1 mg/L. Patients receiving vancomycin for invasive MRSA infections should receive vancomycin monitoring regularly
  5. Community-acquired MRSA, prevalent in the United States as a cause for severe skin and soft tissue infections, has not been described in Israel. Several reasons exist to search for antibiotics other than vancomycin for MRSA infections. Vancomycin is less effective that beta-lactam drugs for SA infections susceptible to both agents
  6. MRSA infections have become increasingly common, with a prevalence of up to 40-50% of all CF patients1; and are associated with an average of 6.2 years shorter life-expectancy compared to CF patients without MRSA. Vancomycin is the drug of choice for the treatment of bronchopneumonia due to MRSA, but it is only available in IV form

High-Dose Vancomycin Therapy for Methicillin-Resistant

  1. Linezolid vs Vancomycin for HA-MRSA Pneumonia Linezolid treatment was associated (in mITT population) with: better clinical response (54.8% vs. 44.9%) fewer days in hospital (17.9 vs. 18.6) less renal failure (4.0% vs. 15.8%) Wunderink, Clin Infect Dis 201
  2. Vancomycin is an antibiotic used to treat serious, life-threatening infections, including those caused by methicillin-resistant Staphylococcus aureus. Vancomycin is given intravenously (by injection into a vein) to treat infections such as blood poisoning (septicemia), heart valve infections (endocarditis), bone infections (osteomyelitis.
  3. バンコマイシン (Vancomycin、VCM) は、グリコペプチド系抗生物質のひとつ 。. 真正細菌の細胞壁合成酵素の基質であるD-アラニル-D-アラニンに結合して細胞壁合成酵素を阻害し、菌の増殖を阻止する働きがある 。 大部分のグラム陽性菌に殺菌作用をもち、腸球菌に対しては静菌作用がある
  4. § Alternatives to vancomycin include linezolid 600 mg PO/IV q12h OR daptomycin 4 mg/kg IV q24h. Type of Infection Suspected Organisms Recommended Treatment Non-purulen
  5. A family memeber was diagnosed with MRSA close to 7 weeks ago. She's been on IV therapy (PICC line) for close to 6 weeks now. Vancomycin has helped but her reactive protein count is still quite high (57.6) as is her sedimentation rate (140). Her Infectious Disease doctor said she'd be on this medication for the full 8 weeks. Here's my questions: 1

Vancomycin - does vancoymcin treat mrsa

In staphylococcus treatment of MRSA infections with vancomycin, an antibiotic often considered as a last line of defense against MRSA, has led to the emergence of vancomycin-resistant S. aureus (VRSA), against which few agents are effective. In 2005 in the United States, deaths from MRSA (approximately 18,000) surpassed deaths from HIV/AIDS (approximatel Methicillin-resistant Staphylococcus aureus (MRSA) is associated with substantial morbidity and mortality. Vancomycin (VAN) has been used as the gold standard treatment for invasive MRSA infections for decades but, unfortunately, the reliance of VAN as the primary treatment option against these infections has led to a reduction in VAN susceptibility in MRSA isolates Vancomycin comes as a capsule to take by mouth. It is usually taken 3-4 times a day for 7-10 days. To help you remember to take vancomycin, take it around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vancomycin exactly as. Vancomycin has been the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections. This agent, however, requires intravenous (IV) administration, and occasionally patients experience unacceptable side effects

PPT - Hospital Acquired Infections PowerPoint Presentation

Methicillin-resistant Staphylococcus aureus and Vancomycin

Health economic evaluation of patients treated for nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus: secondary analysis of a multicenter randomized clinical trial of vancomycin and linezolid. Clin Ther. 2014 Sep 1;36(9):1233-1243.e1. doi: 10.1016/j.clinthera.2014.06.029 ; 25124380 Terico AT, Gallagher JC. Beta-lactam. This study was undertaken to assess whether oropharyngeal vancomycin may control oropharyngeal carriage and lower airway infection due to methicillin‐resistant Staphylococcus aureus (MRSA) acquired in the intensive care unit (ICU). Secondary endpoints were the emergence of vancomycin-resistant enterococci, vancomycin-intermediate S. aureus and vancomycin consumption. A total of 84 patients. invasive MRSA infections exclude nonbacteremic skin and skin structure and urinary tract infections. Since this guideline focuses on optimization of vancomycin dosing and monitoring, recommendations on the appropriate-ness of vancomycin use, combination or alternative antibiotic therapy, and multiple medical interventions tha A newly revised consensus guideline has provided updated recommendations for clinicians treating serious methicillin-resistant Staphylococcus aureus (MRSA) to better achieve clinical efficacy and ensure patient safety.An executive summary of the revised guideline was published in Clinical Infectious Diseases.. Based on recent clinical data, a reevaluation of vancomycin dosing and monitoring.

Proposal: Most community acquired pneumonias with

Vancomycin - StatPearls - NCBI Bookshel

to vancomycin despite the MRSA isolate being sensitive to the antibiotic at MIC 2µg/mL. Electron microscopy of the MRSA isolate showed thickening of the cell wall, which was not observed in MRSA with lower vancomycin MIC. KEY WORDS: MRSA, Vancomycin MIC, Cell wall thickening INTRODUCTION Staphylococcus aureusis generally susceptible to vancomycin associated with vancomycin. Vancomycin dosing based on the area under the curve to minimum inhibitory concentration (MIC), or AUC:MIC ratio, has been demonstrated to reflect clinical success for serious methicillin-resistant Staphylococcus aureus (MRSA) infections. The widely accepted practice of dosing based on vancomycin trough wa

Abstract. Background.Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout the world. The evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance to other non-β-lactams including vancomycin has only amplified the crisis.This paper presents data on the prevalence of MRSA and resistance. Vancomycin is one of the most widely used antibiotics for the treatment of serious gram positive infections involving methicillin-resistant S. aureus (MRSA). However serum vancomycin concentrations are need to be monitored in a relatively narrow range to lessen the potential for nephrotoxicity and ototoxicity and to achieve therapeutic concentrations Tigecycline (Tygacil) has been shown to be noninferior to vancomycin for serious MRSA infections, but the number of patients studied to date has been relatively small. Read the full article. Get.


* Gegen Vancomycin u./o. Co-trimaxol Festlegung der Antibiotikatherapie bei MRSA für die Indikationen: MRSA - Besiedelung, DSF mit MRSA - Infektion, systemische Infektion mit MRSA und schwere systemische Infektion mit MRSA. Cave: Generell sollte vor jeder Vancomycin-Therapie die Nierenfunktion überprüft werden und die Dauer von 14 Tagen nich Guideline: Methicillin-Resistant Staphylococcus Aureus (MRSA) & Vancomycin Intermediate Staphylococcus Aureus (VISA): Infection Control & Management This document reflects what is currently regarded as safe practice. However, as in any clinical situation, there may be factors which cannot be covered by a single set of guidelines Although methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) strains with reduced susceptibility to vancomycin (RVS-MRSA; including vancomycin-intermediate S. aureus [VISA] and heterogeneous VISA [hVISA]) have been linked with vancomycin treatment failure, it is unclear whether they are more pathogenic than vancomycin-susceptible MRSA (VS-MRSA). We prospectively assessed patients. munity MRSA clones on health care-related infections is yet to become clear; regardless, MRSA infections are likely to continue to be a significant problem. The purpose of this review is to explore the possible treatment options available for MRSA including new data related to vancomycin optimization. We will focus on initia Drs. Hwang and Durairaj agreed with this point of view. Dr. Blomquist noted one exception, however: I do use vancomycin prophylactically for open-globe injuries, but that's about the only time that I do. _____ MRSA Ophthalmic Infection, Part 2—A closer look at MRSA-associated orbital cellulitis will appear in next month's EyeNet