Cephalosporins, vancomycin, aminoglycosides and other drugs, especially in combination, for the treatment of methicillin-resistant staphylococcal infections

Abstract

Methicillin-resistant staphylococci (MRS) have become major nosocomial pathogens during the last decade. The infections caused by these organisms occur predominantly in intensive care units, where extensive use of antibiotics takes place. Because of their multiresistant nature, these microorganisms frequently pose difficult therapeutic problems. Emergence of resistance during single-drug therapy further complicates the management of these infections. The use of combination therapy provides theoretically, at least, an answer to some of these difficulties; however, in-vitro and experimental studies need to be confirmed by adequately-controlled clinical trials. Aminoglycosides occasionally may play an important role as companion drugs for cephalosporins or vancomycin in the management of MRS infections. Other drugs such as rifampicin, teicoplanin, fluoroquinolones, and imipenem are to be more extensively investigated, as single-drug therapy or part of a combination regimen, for these difficult staphylococcal infections.