Lincosamide monotherapy treatment of methicillin-resistant Staphylococcus aureus pneumonia in tropical Australia: a case series

TL;DR

This study shows that lincosamide can be an effective treatment for MRSA pneumonia in tropical Australia when the bacteria are susceptible.

Contribution

The study demonstrates lincosamide monotherapy as a safe alternative to vancomycin for MRSA pneumonia in a tropical setting.

Findings

Lincosamide monotherapy was used in 72% of MRSA pneumonia cases.

Patients on lincosamide had similar outcomes to those on vancomycin.

Lincosamide was used in most ICU and bacteraemic patients.

Abstract

Existing recommended first-line antibiotic agents for MRSA pneumonia have several shortcomings. We reviewed 29 cases of community- and hospital-acquired MRSA pneumonia managed at our hospital. Lincosamide monotherapy was administered to 21/29 (72%) and was the predominant antibiotic regimen (> 50% course duration) in 19/29 (66%). Patients receiving lincosamide-predominant monotherapy were no more likely to die or require intensive care unit admission than patients receiving vancomycin-predominant monotherapy (5/19 (26%) versus 4/7 (57%), p = 0.19); 5/7 (71%) patients admitted to ICU and 4/5 (80%) bacteraemic patients received lincosamide-predominant monotherapy. MRSA pneumonia can be safely treated with lincosamide monotherapy if the isolate is susceptible.

The online version contains supplementary material available at 10.1007/s10096-024-04816-9.