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I am responding to information already on patient plus about this infection. I am a consultant microbiologist and was interested to see what information was available. Unfortunately you have quoted the results of a study incorrectly. You state that \"recent evidence suggests that production of the toxins by this bacterium can be reduced by using antibiotics that inhibit cell wall synthesis and so they should be preferred. Beta lactams may produce a worse outcome in PVL-MRSA.\" In fact what the study states is that antimicrobials that affect protein synthesis (such as clindamycin or linezolid) are the ones that reduce toxin production. Cell-wall synthesis is affected by beta-lactam antibiotics (such as flucloxacillin), so your quoted information is contradictory. Also, it is misleading to say that beta-lactam antibiotics may produce a worse outcome in MRSA, as beta-lactam antibiotics are not ever used if it is known that the infection is caused by MRSA. It would be better to say: the use of sub-therapeutic doses of beta-lactams is associated with a poorer response as this encompasses both inadvertent use of beta-lactams in MRSA and the inappropriate use of low dose beta lactam therapy to treat MSSA skin sepsis.[/i]
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