Extent of Anbxs for MRSA resistance

Q: All methicillin-resistant isolates of Staphylococcus aureus (MRSA) should also be considered resistant to all cephalosporins and carbapenems.

A) True

B) False

Answer: B

The answer used to be true, but since the advent of ceftaroline and ceftobiprole (fifth-generation cephalosporins), the answer is now false, as both ceftaroline and ceftobiprole retain activity against MRSA.

As a general rule, all methicillin-resistant isolates should be considered resistant to all beta-lactam antibiotics, including beta-lactamase inhibitor combinations, cephalosporins, and carbapenems, regardless of in vitro susceptibility results.

Other potential available agents are Linezolid, Telavancin, Teicoplanin, and Daptomycin. 

Numerous trials have shown larger efficacy with the combination of different drugs.

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References:

1. Chambers HF. Methicillin-resistant staphylococci. Clin Microbiol Rev 1988; 1:173.

2. Chang J, Tasellari A, Wagner JL, Scheetz MH. Contemporary pharmacologic treatments of MRSA for hospitalized adults: rationale for vancomycin versus non-vancomycin therapies as first line agents. Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(12):1309-1325. doi: 10.1080/14787210.2023.2275663. Epub 2023 Nov 24. PMID: 37876291.

3. Cosimi RA, Beik N, Kubiak DW, Johnson JA. Ceftaroline for Severe Methicillin-Resistant Staphylococcus aureus Infections: A Systematic Review. Open Forum Infect Dis 2017; 4:ofx084.

4. Soriano A, Morata L. Ceftobripole: Experience in staphylococcal bacteremia. Rev Esp Quimioter 2019; 32 Suppl 3:24.