Middle East Journal of Family Medicine

JOURNAL

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March 2023 - Volume 21, Issue 2
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From the Editor

Editorial
A. Abyad (Chief Editor)
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Editorial
Abdulrazak Abyad

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Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE
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March 2023- Volume 21, Issue 2

Overview Methicillin-Resistant Staphylococcus Aureus Combination Treatment Options in Vivo and in Vitro

Ahmed Y. Mobarki1, Ibrahim M. Dighriri2, Ahmed S. Alotaibi2, Manal M. Mobarki2, Wael M. Alsufyani2, Sultan F. Almutairi3, Fahad N. Alharthi4, Mohammed H. Alessa4, Dhafer G. Alqahtani5, Mohammed S. Almurayt6, Shoug M. Aljuaid7, Rahaf A. Alotaibi7, Nawaf R. Alsuwayidi8, Khalaf A. Albaqqar9,Othayman G. Alqahtani10

(1) Department of Molecular Biology, Regional Laboratory and Central Blood Bank, Abha, Saudi Arabia.
(2) Department of Pharmacy, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia.
(3) Department of Pharmacy, King Fahd Specialist Hospital, Al Qassim, Saudi Arabia.
(4) Department of Pharmacy, King Abdulaziz Hospital, Makkah, Saudi Arabia.
(5) Department of Pharmacy, Wadi Aldawaser Hospital, Wadi Aldawaser, Saudi Arabia.
(6) Department of Pharmacy, Armed Forces Hospital Southern Region, Abha, Saudi Arabia.
(7) Department of Pharmacy, Community Pharmacy, Taif, Saudi Arabia.
(8) Pharmaceutical Care Services, Prince Sultan Armed Forces Hospital, Taif, Saudi Arabia.
(9) Department of pharmacy, Prince Mishari bin Saud Hospital, Albaha, Saudi Arabia.
(10) Department of Clinical Service Line, Riyadh First Health Cluster, Riyadh, Saudi Arabia

Corresponding author:
Ibrahim M. Dighriri
Department of Pharmacy, King Abdulaziz Specialist Hospital,
Taif, Saudi Arabia
Email: ibrahimdaghriri1411@gmail.com

Received: February 2023 Accepted: February 2023; Published:March 1, 2023. Citation: Ahmed Y. Mobarki et al. Overview Methicillin-Resistant Staphylococcus Aureus Combination Treatment Options in Vivo and in Vitro. World Family Medicine. March 2023; 21(2): 82-91 DOI: 10.5742/MEWFM.2023.95256058

Abstract

The spread of multidrug-resistant Staphylococcus aureus continues to threaten global health. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the common causes of bacterial infections in hospitals and communities. Despite vancomycin being an effective treatment for MRSA, from 2006 to 2020, vancomycin-resistant MRSA increased 3.5-fold, from 5% to 7%. Bacterial genome mutations, as well as bacteria’s ability to transfer genetic material with other bacteria, allowing them to obtain resistance genes from different strains, are all factors contributing to the development of vancomycin resistance in MRSA. As a result, combination therapy may be a potential treatment for MRSA infection. We searched in PubMed and Google Scholar, and our search yielded 92 articles, out of which 74 full-text articles were reviewed and 56 were selected for this study. This literature review examines combination therapies for MRSA infections, such as -Lactams with vancomycin, linezolid and imipenem, daptomycin and ceftaroline. The review yielded several studies looking at the synergy between -lactams and vancomycin. Although linezolid and rifampicin demonstrate synergy against MRSA in vivo and in vitro in various invasion diseases, more clinical research is required to prove their efficacy. Furthermore, daptomycin plus ceftaroline shows synergy for refractory staphylococcal bacteremia in vivo and in vitro. Combining ceftaroline and daptomycin has two benefits: they work synergistically together and make the innate host defense peptide cathelicidin leucine-leucine-37 (LL-37) more sensitizing. Ceftaroline plus daptomycin was recently used in MRSA biofilm infections, demonstrating a potentially promising treatment as the first combination used without side effects in humans.

Keywords: Bacteremia, Vancomycin, Daptomycin, Ceftaroline, Staphylococcus aureus, MRSA.

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