Antibiotic therapy of vascular catheter-related bloodstream infections: is vancomycin the optimal choice for Staphylococcus aureus infections?

Vancomycin is frequently used as empirical therapy in patients with catheter-related bloodstream infections and for definitive therapy of such infections caused by meticillin-resistant Staphylococcus aureus. Evidence, however, indicates that as a consequence of decreasing activity of vancomycin against this organism, as well as with deficiencies in tissue penetration, vancomycin therapy of such infections frequently results in microbiological and clinical failure. The relative efficacy of alternative therapies requires urgent investigation in randomized clinical trials.