Who's winning the war?

Abstract

Traditionally, methicillin-resistant Staphylococcus aureus (MRSA) has been seen as an infection control problem in healthcare communities. It is now clear that antibiotic use is also an important factor in the control of MRSA, both in the treatment of infection and also, paradoxically perhaps, as a cause of the MRSA problem, in the same way that antibiotic use causes Clostridium difficile disease. At both levels, major improvements in the quality of our antibiotic use are required, particularly antibiotic stewardship to reduce the selection, maintenance and transmission of MRSA strains. In addition, new agents are required to reduce our reliance on glycopeptides for the treatment of serious MRSA infections. Daptomycin has great promise in this regard as its rapid bactericidal activity makes it particularly suitable for the treatment of bacteraemia and endocarditis. © The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.