In suspected MRSA infection, what is the general approach to antibiotic choice?

• A. Start with a broad-spectrum beta-lactam monotherapy
• B. Use MRSA-active agents such as vancomycin, linezolid, or doxycycline depending on severity; avoid beta-lactam monotherapy
• C. Wait for culture results before starting antibiotics
• D. Use doxycycline alone for all severity levels

Answer: (B)

When MRSA is suspected, you treat with antibiotics that have activity against MRSA rather than relying on beta-lactam monotherapy, because MRSA is resistant to most beta-lactams. The general approach is to start MRSA-active therapy and tailor the choice to how severe the infection is and where it’s located. For serious or systemic infections, vancomycin or linezolid given by IV are reliable options that cover MRSA and reach infected tissues. For milder cases, doxycycline can be considered, particularly in outpatient settings, but the specific choice depends on the infection site and patient factors. De-escalate to the narrowest effective therapy once culture results confirm the pathogen, and avoid using beta-lactams alone when MRSA is a concern since they may fail.