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JAC Advance Access originally published online on February 11, 2003
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Journal of Antimicrobial Chemotherapy (2003) 51, 731-735
© 2003 The British Society for Antimicrobial Chemotherapy

Oral streptogramins in the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections

S. J. Dancer1,*, A. Robb1, A. Crawford1 and D. Morrison2

1 Department of Microbiology, Vale of Leven District General Hospital, Alexandria G83 0UA; 2 Scottish MRSA Reference Laboratory, Stobhill Hospital, Glasgow G21 3UW, UK

Received 29 August 2002; returned 19 October 2002; revised 27 December 2002; accepted 6 January 2003

Objectives: Chronic methicillin-resistant Staphylococcus aureus (MRSA) infections in debilitated patients are difficult to treat. We studied the clinical efficacy and safety of an oral streptogramin, pristinamycin, for these patients.

Patients and methods: Patients were admitted consecutively to receive pristinamycin, usually with doxycycline, for 7–21 days. Fifty-six patients (average age 75 years) from hospital and community were treated for skin, soft tissue, chest and other infections.

Results: The overall clinical response rate was 39 of 53 patients (74%; 95% CI: 60%, 85%) cured or substantially improved, from 53 of 56 (95%) patients clinically and 49 of 56 (87.5%) patients bacteriologically evaluable. Toxic effects comprised gastrointestinal disturbances in eight patients (14%) and one (2%) possible skin rash.

Conclusion: This study suggests that oral streptogramins may be useful in the management of debilitated patients with MRSA infections.

Keywords: oral streptogramins, MRSA infections

* Correspondence address. Scottish Centre for Infection and Environmental Health, Clifton House, Clifton Place, Glasgow G3 7LN, UK. Tel: +44-141-300-1100; Fax: +44-141-300-1172; E-mail: Stephanie.dancer{at}scieh.csa.scot.nhs.uk


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