Investigation of the treatment management of MRSA sepsis, pneumonia

review of the published literature surveying the effects of therapeutic adjunct to MRSA infection

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infection has become a serious problem in Japan. There are many intractable cases in MRSA infection. Rifampicin and trimethoprim/sulfamethoxazole are used to treat patients as an adjunct to MRSA infection antibiotics. Therefore, we reviewed the published literature using the PubMed and Ichushi in order to examine the effects of rifampicin or trimethoprim/sulfamethoxazole combination therapy in the treatment of MRSA pneumonia and sepsis. One randomized controlled trial and 1 case-control study have examined the effectiveness of rifampicin in the treatment of sepsis. Neither of the studies showed statistically significant differences in efficacy between RFP combination drug therapy group and monotherapy group. However, several case reports have identified the efficacy. One randomized controlled trial has examined the effectiveness of rifampicin in the treatment of MRSA pneumonia, in which statistically significant differences was shown in efficacy between RFP combination drug therapy group and monotherapy group. There were only a few data regarding the use of trimethoprim/sulfamethoxazole combination for treatment of MRSA sepsis and pneumonia. Our literature survey suggests that rifampicin or trimethoprim/sulfamethoxazole combination therapy can be a therapeutic option for MRSA sepsis and pneumonia.