Which of the following medications should be considered for the treatment of MRSA VAP? I. vancomycin II. trimethoprim/sulfamethoxazole III. linezolid IV. cloxacillin
A. I only
B. I, II, III only
C. I, III, IV only
D. II, III, IV only
?ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: The use of vancomycin to treat suspected or confirmed MRSA is common practice in most ICUs. However, recent studies suggest a poor outcome in some patients with both MRSA and MSSA pneumonia when treated with vancomycin, possibly because of poor penetration to the alveolar space. Based on studies, the recommendation is that vancomycin should not be considered the agent of choice for the treatment of MRSA VAP. Agents such as linezolid, teicoplanin. or trimethoprim/sulfamethoxazole should be considered for the treatment of MRSA.
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