Format

Send to

Choose Destination
Ann Pharmacother. 2019 Jun 10:1060028019856721. doi: 10.1177/1060028019856721. [Epub ahead of print]

What Is the Evidence for Co-trimoxazole, Clindamycin, Doxycycline, and Minocycline in the Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) Pneumonia?

Author information

1
1 Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada.
2
2 The University of British Columbia, Vancouver, BC, Canada.
3
3 Vancouver General Hospital, Vancouver Coastal Health, Vancouver, BC, Canada.

Abstract

OBJECTIVE:

To review the evidence for trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, doxycycline, and minocycline in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia.

DATA SOURCE:

MEDLINE, PubMed, EMBASE, Google, Google Scholar, Cochrane Central Register of Controlled Trials from 1946 to May 20, 2019. The search was performed with the keywords methicillin-resistant Staphylococcus aureus, MRSA, Staphylococcus aureus, pneumonia, trimethoprim, sulfamethoxazole drug combination, trimethoprim, sulfamethoxazole, TMP-SMX, co-trimoxazole, clindamycin, doxycycline, and minocycline.

DATA EXTRACTION:

Studies reporting the use of the above antibiotics for MRSA pneumonia treatment with clinical outcomes were included. Search parameters were limited to English language and human studies only.

DATA SYNTHESIS:

The search yielded 16 relevant articles: 6 TMP-SMX, 8 clindamycin, zero doxycycline, and 2 minocycline. For TMP-SMX, prospective randomized trials showed variable results; however, these studies were not specifically designed to assess MRSA pneumonia treatment. Retrospective studies with clindamycin suggested that it could be used as monotherapy or in combination with other anti-MRSA antibiotics. There was no evidence for doxycycline use, but 2 small retrospective reviews appeared to support minocycline as a treatment option. Relevance to Patient Care and Clinical Practice: These antibiotics are often used in clinical practice as potential treatment options for MRSA pneumonia. This article reviews the evidence for the clinical efficacy and safety of these agents.

CONCLUSIONS:

There are limited data to support use of TMP-SMX, clindamycin, doxycycline, or minocycline in MRSA pneumonia treatment. Randomized controlled trials are required to determine the effectiveness of these antibiotics. Clinicians should base their decision to use these agents on a case-by-case basis depending on clinical status and susceptibility results.

KEYWORDS:

MRSA pneumonia; clindamycin; co-trimoxazole; doxycycline; minocycline

PMID:
31177803
DOI:
10.1177/1060028019856721

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center