Relationship between Clinical Factors and Intake of Nutrition on Treatment of MRSA Infection

Abstract

  Some cases of methicillin-resistant S. aureus (MRSA) infection are not resolved effectively despite the administration of anti-MRSA drugs, because patients with severe MRSA infection may have poor nutrition and body condition. To identify the factors influencing the therapeutic effect of anti-MRSA drugs, clinical data, sensitivity of MRSA to anti-MRSA drugs, and drug concentration were investigated in 64 cases from November 2003 to March 2006 by multivariate logistic regression analysis. As a result, 32 cases in the efficacious group and 32 cases in the non efficacious group were identified. Therapeutic drug monitoring (TDM) of anti-MRSA drugs found 100% vs. 71.9%, respectively (p=0.004). Age (Odds rate (OR)=0.94), and increased serum total protein (TP) during treatment of anti-MRSA drugs (OR=2.46) were found to be significant factors. Pharmocokinetic parameters of anti-MRSA drugs and sensibility of MRSA were not significant. Serum TP amount increased during treatment in many patients in the efficacy group, in whom the nutrition had been taken by oral or nasogastric tube. Increased serum TP and feeding via gastrointestinal tract may be related. Therefore, treatment of MRSA infection requires administration of anti-MRSA drugs using TDM, and improvement of nutrition and the route of feeding, together with close cooperation with the nutrition support team.