Do you use an antibiotic with antitoxin activity for the entire duration of therapy for patients with necrotizing MSSA or MRSA pneumonia or just until definitive clinical improvement?

I misread the question. I assumed a necrotizing S. aureus infection meant a necrotizing skin and soft-tissue infection. I’m not sure how “necrotizing pneumonia” is being defined here.

Regarding MRSA pneumonia with toxin-mediated tissue injury, there are data suggesting that linezolid may yield better clinical outcomes than vancomycin in MRSA pneumonia. By the way, we have anti-toxin antibodies, but no antibiotic is truly an anti-toxin. I assume the question is really about antibiotics that inhib...

I use targeted therapy to the organism identified; if I do not have an organism yet and the patient has appropriate risk factors for MRSA necessitating empiric coverage, I do favor linezolid but specifically for its data in pneumonia and not its use in necrotizing fasciitis/toxin data. Once I have an organism, I streamline therapy to be as targeted as possible, considering stewardship principles and likely prolonged duration, considering these are frequently empyemas requiring long therapy. I ha...