Mortality of MRSA bacteremia in relation to MIC and vancomycin use

In MRSA bacteremia, when the vancomycin MIC exceeds 1 the mortality is increased in patients treated with vancomycin. The study was reported here in Clinical Infectious Diseases.

According to Medscape’s coverage of the study:

"These findings suggest that empirical vancomycin treatment when MRSA infection is suspected should be administered using a trough serum concentration of at least 20 mcg/mL as a target until a precise MIC is obtained, and it would be necessary to clarify whether new antistaphylococcal agents, such as linezolid, daptomycin, tigecycline or dalbavancin, could be superior to vancomycin when the strain has a vancomycin MIC > 1 mcg/mL," the authors conclude.

This study is from Spain. I’m not sure how it applies to the U.S., but I’ll be looking closely at the MICs of my patients with MRSA bacteremia.