MRSA risk - guidance on selection of antimicrobial prophylaxis and empirical treatment regimens

Risk Factors

Patients within these categories are considered at increased risk of MRSA infection:

1. Known colonisation with MRSA at any site at any time.
2. Known previous infection with MRSA (requiring antimicrobial treatment) at any time.
3. Resident of a long term care facility (nursing home, residential home or any other long term residential facility) without a negative MRSA screening result.
4. Current inpatient and in hospital for greater than 14 days.

If a patient has risk factors for MRSA infection:

• MRSA should be considered when choosing empirical (best guess) antimicrobial treatment regimens for infection.
• They should receive surgical prophylaxis with activity against MRSA as specified in specialty-specific prophylaxis guidelines.
• Where no specialty specific prophylaxis guidelines exists teicoplanin IV bolus 400mg within 1 hour prior to incision/tourniquet application as a single dose may be appropriate, discussion with microbiology is advised.
• Where patient is allergic to teicoplanin seek microbiology advice.
• Topical decolonisation should be administered according to the screening and decolonisation protocol.