The subject of effectiveness of vancomycin for MRSA (methicillin-resistant staphylococcus aureus) is evolving. Just as some strains of staphylococcus developed resistance to many common antibiotics, it’s now clear that these germs continue to change. In other words, they evolve new resistances to the newer treatments and there are now some strains of MRSA that are also vancomycin resistant. Dubbed VR-MRSA, these may change available antibiotics for MRSA treatment in the future, though for now, vancomycin is still viewed as one of the most effective drugs and often one of the drugs of last resort when MRSA won’t respond to other types of treatment.
Close to the 2010s, there have been numerous clinical trials suggesting the efficacy of vancomycin for MRSA. Across the board, such trials show that 80% or more of cases may be effectively treated with this antibiotic. Another drug that also is nearly as effective is tigecylcine. Both have about the same possibility of side effects, with tigecycline tending to create greater nausea. There are other medications that may be used when these combinations fail, and successful treatment may ultimately depend on the type of strain. If VR MRSA is present, vancomycin is of little use.
While vancomycin for MRSA can be effective, it isn’t always the first drug of choice. First off, community acquired forms of MRSA may not even be treated with antibiotics at all times. Sometimes simply draining any abscesses and keeping them clean is enough to resolve a MRSA infection. Alternately, an antibiotic that isn’t methicillin based or any other medication to which MRSA may not have resistance could be considered before vancomycin.
The reason why vancomycin for MRSA often gets called a treatment of last resort is because there are good reasons not to use it, too. Its overuse has led to other superbugs, like vancomycin-resistant enterococci (VRE), which can cause difficult stomach infections that are extremely challenging to resolve. Avoidance of creating more VRE or VR MRSA drives this concern. Moreover, doctors don’t want to infect patients with VRE by curing them of MRSA, which might occur in medically vulnerable patients. This means unless doctors deem it absolutely necessary, they may look to other medications first before they turn to using vancomycin for MRSA.
Determining the best treatment for antibiotic-resistant germs is always a delicate balance. The right medicine should effectively cure the condition, run least risk of dangerous side effects and have the lowest tendency to cause a germ to further evolve and become harder to treat in the future. Vancomycin for MRSA only really serves one of these categories: it can effectively cure MRSA provided VR MRSA isn’t present. It does have side effects and may cause evolution of MRSA bacteria, so it can’t ultimately be the best choice in all circumstances. Finding a medication that is the best choice proves very difficult, though much study continues on this matter.
