Антибиотики и Химиотерапия (May 2020)
Current Problems of Infections Caused by MRSA and Ways to Address Them
Abstract
The increase in the growth rate of MRSA as an etiologic factor has been recorded worldwide in recent years. The main problem of antibiotic resistance in Staphylococcus aureus is its resistance to beta-lactam antibiotics. Previously, MRSA has traditionally been considered as an exclusively nosocomial pathogen, but in recent years it has become prominent in patients with community-acquired infections, mainly of skin and soft tissues. The proportion of infections caused by MRSA in hospitalized patients is steadily increasing, and the antibiotic drugs most often used in clinical practice with anti-MRSA activity have certain usability limitations due to the safety profile, the need for therapeutic drug monitoring or intensive laboratory monitoring during therapy. The appearance of a new representative of oxazolidinone class of antibiotics - tedizolid - is important for the treatment of infections caused by MRSA. Tedisolid is 4-32 times more active against staphylococci, enterococci and streptococci in vitro than linezolid. It is potentially important that many strains resistant to line-zolid maintain in vitro susceptibility to tedizolid. Two Phase 3 studies in patients with acute bacterial skin and soft tissues infections have shown that a relatively short course of therapy with tedizolid at a dose of 200 mg once daily for 6 days is not inferior in effectiveness and safety to the standard long-term linezolid course at a dose of 600 mg 2 times per day for 10 days. In general, the number of clinical studies of tedizolid is limited, but the available data allow to consider it as an effective drug with a favorable safety profile, registered for the treatment of complicated skin and soft tissue infections, including the ones caused by G(+) pathogens resistant to other antibiotics.
