Staphylococcus aureus antibiotic therapy

Oral, narrow-spectrum antibiotic therapy with activity against Staphylococcus aureus and streptococcal species. Include coverage for MRSA (HA- or CA-MRSA) according to patient history and resistance patterns in the area. 

These antibiotics are considered as a choice of last resort where every other antibiotic therapy has failed. The first and only commercially available oxazolidinone antibiotic is linezolid which was introduced in 2002. Its mechanism of action is inhibition of bacterial protein synthesis. It is available for intravenous administration and also has the advantage of having excellent oral bioavailability. Linezolid is used for the treatment of infections caused by multi-resistant bacteria including streptococcus and methicillin-resistant Staphylococcus aureus (MRS A). 

Mild cases, characterised by pinkness or infection of the eardrum, often resolve spontaneously and need only analgesia emd observation. They are normally viral. A bulging, inflamed eardrum indicates bacterial otitis media usually due to Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Bran-hamella) catarrhalis. Streptococcus pyogenes (Group A) or Staphylococcus aureus. Amoxicillin or co-amoxiclav is satisfactory, but the clinical benefit of antibiotic therapy is very small when tested in controlled trials. Chemotherapy has not removed the need for myringotomy when pain is very severe, and also for later cases, as sterilised pus may not be completely absorbed and may leave adhesions that impair hearing. Chronic infection presents a similar problem to that of chronic sinus infection, above. 

An important practical aproach can be derived from that different distribution of the two IPI types among the different kingdoms. As type II isomerase in essential in some human pathogens including Staphylococcus aureus and Enterococcus faecalis, it may represent a novel target molecule for antibiotic therapy [311]. 

DiNubile Ml. Short-course antibiotic therapy for right-sided Staphylococcus aureus endocarditis in injection drag users. Ann Intern Med 1994 121 873-876. 

Infections in cystic fibrosis are often due to Staphylococcus aureus, Haemophilus influenzae or Pseudomonas aeruginosa. Infecting organisms need to be identified so that the most appropriate antibiotics can be used. Antibiotics used to treat respiratory infections in cystic fibrosis commonly include ciprofloxacin, erythromycin, flu-cloxacillin and amoxicillin. However, specialist individual therapy is essential for maximum benefit to the patient and avoidance of the development of resistant strains of bacteria. 

Azithromycin, an azalide macrolide antibiotic (500 mg p.o. as a single dose on day 1, followed by 250 mg daily on days 2 to 5 total accumulation dose is 1.5 g), is indicated in the treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or S. agalactiae second-line therapy of pharyngitis or tonsillitis caused by S. pyogenes and in nongonococcal urethritis or cervicitis caused by Chlamydia trachomatis. 

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