is a cause of staph infection that is

difficult to treat because of

resistance to some antibiotics.
Staph infections—including those
caused by MRSA—can spread in
hospitals, other healthcare
facilities, and in the community
where you live, work, and go to
school.
Resistant to all beta-lactams
( methicillin/penicillin/
amoxicillin/oxacillin

Methicillin-resistant Staphylococcus
aureus
 MRSA is caused by a certain
bacteria that is resistant to many
antibiotics that are used to create
regular staph infection
Population at risk
Diabetics
Student athletes
Elderly
Using quinolone antibiotics
Weakened immune system(HIV/AIDS,
LUPUS, CANCER) SYMPTOMS
1941-over 90% of staphylococcal isolates • Swollen, painful and red bumps on
were susceptible to treatment with skin
penicillin • Warmness in affected area
• Pus or other abnormal drainage
• fever
Pathogenesis Protein
antibody Adhesins
MRSA molecule
Protein A
fcr fbp
cbp
fab
fc
Y
Staph a. plasmid Capsule-
resist
phagocytosis phagocytosis

DNA
Exotoxins Cell wall
TSST-1
enterotoxins

invasins
Coagulase- converts
Form fibrin clot
fibrinogen to fibrin
Staphylokinase-
Plasmin-
activates
breakdown
plasminogen
fibrin clot
In MRSA infection, S. aureus develops resistance to Beta-lactam
producing antibiotics through synthesis of penicillin-binding
protein 2a (PBP2a). PBP2a has a low affinity for Beta-lactams
allowing for transpeptidase activity and cell wall synthesis. As a
result the bacterium continues to grow and reproduce.

Many of these bacteria produces penicillinase

( beta-lactamase) renders antibiotic to be ineffective

Beta- lactamase enzymes commonly found in

transmittable plasmid which can be traded between
bacteria essentially like trading cards
 TYPES OF Methicillin- Resistance Staphylococcus aureus (MRSA)
are categories by where they are acquired
Healthcare-acquired MRSA- (HA_MRSA)
- Transmitted in hospitals/ healthcare facilities
- Weakened immune system/ recent surgery/ medical
device

Community – acquired MRSA- (CA_MRSA)

- Childcare settings/ long term care facilities
- Athlete settings/towel
sharing
 Pharmacological Management

Vancomycin or daptomycin are the agents of choice for

treatment of invasive MRSA infections ,Alternative agents that may
be used for second-line or salvage therapy include telavancin,
ceftaroline, and linezolid.
 Vancomycin
Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of
serious staphylococcal infections. It is the alternative therapy of choice when the penicillins
and cephalosporins cannot be used.

MECHANISM OF ACTION
Pharmacokinetics
 
Recommended dosing schedule
Absorption:
 >1 month-6 yrs: 40mg/kg/day divided every 6 hours
Vancomycin is poorly absorb orally in GIT
 >6 years -18 years: 40mg/kg/day divided every 8
When given parenterally drug distributes widely into
hours
tissues
 >18 years: 15mg/kg/day divided every 8 hours
Cmax 63mcg/ml
 Uncomplicated infections: 10-15 mg/kg q12h1
Tmax is 1 hr
 Serious Infections: Consider loading dose of
 
25mg/kg iv, followed by 15-20 mg/kg 8-12h (45-
Distribution:
60mg/kg/day divided 12h or 8h)
 
55% protein bound
Vd is 0.3 to 0.43 L/kg
Distributes well into pleural, pericardial and synovial
fluid.
Elimination:
Intraveneous -about 75% is excreted in urine by GFR (in
24 hours) as a unchanged
Mean half life is 4-6 hours
Oral: Feaces
 ADVERSE EFFECT

Vancomycin may cause side effects.

•nausea.
•vomiting.
•stomach pain.
•diarrhea.
•gas.
•headache.
•back pain.
 Daptomycin
is a cyclic lipopeptide antibiotic used to treat complicated skin and akin structure
infections by susceptible Gram-positive bacteria and bacteremia due to
staphylococcus aureus.

Mode of Action
Pharmacokinetics

Distribution: Daptomycin has a very small volume of

distribution, averaging -0.1 L/kg in healthy adult
subjectsindependent of dose the volume of distrinution tends
to increase with decreasing renal function, being estimated at
-0.2 L/kg in atient with severe renal impairement

Absorption: No absorption

Metabolism: studies using human hepatocytes suggest that

side effect
daptomycin effectively does not interact at all with the
nausea.
various CYP450 enzymes present in the liver.
vomiting.
Excretion: primarily excreted by the kidneys. stomach pain.
diarrhea.
Recommended dosing schedule gas.
6 mg/kg/dose IV every 24 hours for 2 to 6 weeks is the headache.
FDA-approved dosage. Doses of 8 to 10 mg/kg/dose IV back pain.
every 24 hours may be warranted for MRSA. 
 Linezolid antibiotic

commonly used in treating skin and soft‐tissue infections, specifically those

infections due to methicillin‐resistant Staphylococcus aureus (MRSA).

MECHANISM OF ACTION
Recommended dosing schedule
For oral dosage forms (suspension or tablets):
 For bacterial infections:
o Adults and children 12 years of age and older—400 or 600 milligrams (mg) every 12 hours.
o Children younger than 12 years of age—Dose is based on body weight and must be determined by your
doctor. The dose is usually 10 milligrams (mg) per kilogram (kg) of body weight every 8 or 12 hours as
determined by your doctor.

Side effect
More common
 Chills
 confusion
 diarrhea
 dizziness
 fainting
 fast heartbeat
 fever