Protocolo para el manejo de las infecciones graves por Staphylococcus aureus

Abstract

Staphylococcus aureus (SA) infections are common and have a high morbidity and mortality. The main antibiotics for treating methicillin-sensitive SA (MSSA) are cloxacillin and cefazolin. The main drugs for treating methicillin-resistant SA (MRSA) are vancomycin and daptomycin. Other antibiotics that may be of use include linezolid, rifampicin, or fluoroquinolones. In the empirical treatment of SA infections, the risk of MRSA must be taken into account. The treatment target and its duration, in absence of bacteremia, is conditioned in large part by the source of the infection and whether it is suitably controlled or not. When bacteremia is present, the possibility of infectious endocarditis must be evaluated and follow-up blood cultures must be conducted until they are negative. For uncomplicated bacteremia, 14 days of treatment from the first negative blood culture are necessary whereas if the bacteremia is complicated, treatment must have a duration of at least 28 days.