Do you use MRSA nares PCR to influence antibiotic selection for non-respiratory infections?

BLUF: Yes, I use a MRSA nares PCR for early de-escalation in the stable patient with a non-purulent, non-respiratory infection.

Mergenhagen et al., PMID 31573026 retrospectively examined nearly half a million clinical cultures and compared them to MRSA nares results. Among all infections, the NPVs w...

I answered this question, I believe, last September. I have re-reviewed the literature. There is not a single RCT demonstrating that empiric MRSA coverage can be safely discontinued on the basis of a negative nasal MRSA screen.

As discussed previously, the VA Clinical Infectious Diseases study had a ...

I reviewed this recent short article with my teaching team last week, which suggests that MRSA nares PCR can influence antibiotic selection for some non-respiratory infections, but its usefulness depends heavily on the infection and local MRSA prevalence. For diabetic foot infections, a negative nar...

Yes, this can be used in cellulitis to help guide antibiotic coverage, especially initially - most evidence is in pneumonia but this can be used to guide empiric treatment. Good article below:

Liu and Holubar, PMID 38319836

No. Including because the organism can colonize elsewhere, axilla and groin. And perhaps also because my hospital does culture, not PCR. I have not yet had the impression that testing for MRSA colonization has any practice-changing value with regard to treatment of an active infection, other than th...