Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is associated with high morbidity and mortality. There is no consensus about the length of therapy. Current Infectious Diseases Society of America consensus guidelines recommend 7 to 21 days for duration.
In a retrospective study conducted in a 900-bed teaching hospital in urban Detroit over a 26-month period, we evaluated the charts of 706 patients with positive MRSA respiratory cultures. We studied 115 patients with MRSA pneumonia.
The mean ± SD age for the patients was 64.36 ± 14.44 years; 67 patients (58.77 %) were women, 44 patients (38.26%) had multilobar pneumonia. Patients were treated with either vancomycin or linezolid or treatment was switched between those 2 agents. The mean ± SD treatment duration was 13.1 ± 7.1 days. The overall 28-day mortality rate was 28.73% (n = 32). Among the 83 patients who survived to 28 days, 9 patients (10.8%) received treatment for less than 8 days, 33 patients (39.8%) received treatment for 8 to 13 days, 26 patients (31.3%) received treatment for 14 to 20 days, and 15 patients (18.1%) received treatment for more than 20 days. Among the 32 patients who did not survive to 28 days, 11 patients (34.4%) received treatment for less than 8 days, 14 patients (43.8%) received treatment for 8 to 13 days, 6 patients (18.8%) received treatment for 14 to 20 days, and 1 patient (3.1%) received treatment for more than 20 days; P < 0.001.
The nonsurvivors were treated for shorter durations than survivors, indicating that MRSA pneumonia requires longer treatment durations (≥14 days).
From the *Division of Infectious Diseases, Henry Ford Health System, Detroit; †Division of Internal Medicine, Hurley Medical Center, Flint; and ‡Division of Internal Medicine, Henry Ford Health System, Detroit, MI.
Correspondence to: Hadeel Zainah, MD, Henry Ford Hospital, 2799 W Grand Blvd, CFP-304 Detroit, MI 48202. E-mail: email@example.com.
H Zainah, R Nakhleh, and S Hassan have no conflicts of interest to disclose. S Arshad has received grant support from Pfizer. M Zervos has received grant support from Cubist and Pfizer and honorarium for speaking for Souvinon.
No funding was received for this study.