Drug used for treatment of methicillin resistant staphylococcus aureus is:
Correct Answer: Vancomycin
Description: Vancomycin is a glycopeptide antibiotic discovered in 1956 as a penicillin substitute which has assumed special significance due to efficacy against MRSA Strep. viridans, Enterococcus and Cl. difficile. It is bactericidal to gram-positive cocci, Neisseria, Clostridia and diphtheroids. However, in hospitals where it has been extensively used for surgical prophylaxis, etc., vancomycin-resistant Staph. aureus (VRSA) and vancomycin-resistant Enterococcus (VRE) have emerged. These nosocomial bacteria are resistant to methicillin and most other antibiotics as well. Vancomycin acts by inhibiting bacterial cell wall synthesis. It binds to the terminal dipeptide 'D-ala-D-ala' sequence of peptidoglycan unitsprevents its release from the bactoprenol lipid carrier so that assembly of the units at the cell membrane and their cross linking to form the cell wall cannot take place Enterococcal resistance to vancomycin is due to a plasmid mediated alteration of the dipeptide target site, reducing its affinity for vancomycin. Systemic use (500 mg 6 hourly or 1 g 12 hourly infused i.v. over 1 hr) is restricted to serious MRSA infections for which it is the most effective drug. and as a penicillin substitute (in allergic patients 1 for enterococcal endocarditis along with gentamicin. For empirical therapy of bacterial meningitis, i.v. vancomycin is usually combined with i.v. ceftriaxone/ cefotaxime. It is also used in dialysis patients and those undergoing cancer chemotherapy. Penicillin-resistant pneumococca: infections and infection caused by diphtheroids respond very well to vancomycin. It is the preferred surgical prophylactic in MRSA prevalent areas and in penicillin allergic patients. Essentials of medical pharmacology K D Tripathi Sixth edition Pg 732
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Pharmacology
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