Please note: This is for information only.

Refer to local guidelines for treatment recommendations.

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• A Gram-positive coccus that is often found colonising on the skin of the anterior nares, axilla, and perineum.
• The methicillin (flucloxacillin) resistant version (MRSA) is a particular infection control hazard.
• S. aureus in general, (MRSA or MSSA) is a common agent of nosocomial infections in hospitals.
• Currently, between 40-50% of healthcare-associated S aureus infections are due to MRSA, but <5% of true community S aureus infections

Main clinical infections:

• Skin and soft tissue infections (impetigo, cellulitis)
• Surgical ward infections
• Venflon infections
• Intravascular catheter infections (often with bacteraemia).
• Severe systemic infections in deep foci such as endocarditis, osteomyelitis, myositis, and fasciitis.

MSSA: Usually sensitive to:

• Flucloxacillin
• Co-amoxiclav
• 1st and 2nd generation cephalosporins
• Gentamicin
• Erythromycin
• Doxycycline
• Fusidic acid
• Rifampicin
• Clindamycin
• Trimethoprim
• Vancomycin
• Seek microbiology advice for synergistic drug combinations in severe infections.

MSSA: Usually resistant to:

• Benzylpenicillin
• Amoxicillin
• Ceftazidime

MRSA: (multiple-resistant organism): Usually sensitive to:

• Vancomycin (1st line choice for i.v. therapy)
• Doxycycline (1st choice for p.o. therapy in less severe infections)
• Teicoplanin
• Gentamicin (Gentamicin resistance in MRSA is thankfully uncommon in Nottingham.)
• Trimethoprim
• Fusidic acid
• Rifampicin

MRSA: Usually resistant to:

• All beta-lactam antibiotics (e.g. penicillins, flucloxacillin, cephalosporins, co-amoxiclav, imipenem),
• Quinolones (e.g. ciprofloxacin and levofloxacin),
• Macrolides (erythromycin, clarithromycin)