Vancomycin can also have serious side effects. Patients can develop experience liver and kidney damage. Alternative antibiotics in use are linezolid and flucloxacillin.
Flucloxacillin is more common in community practice. In l994 a warning was placed on the listing of its use due to a possible association with cholestatic hepatitis. However, with MRSA infections, the morbidity and potential mortality are high and the benefits of flucloxacillin far outweigh the risks.
Linezolid is also effective. Infact, it may be equivalent to Vancomycin in the treatment of MRSA infections. Research conducted by the Department of Veterans Affairs concluded that this is safer than vancomycin
There is also a class of antibiotics which may work on destroying the biofilm MRSA cause on medical equipment such as catheters. The biofilm provide MRSA with extra protection against antibiotics. Therefore, the outer membrane of MRSA is more likely to be destroyed.
Modulations of antibiotics policies alone do not ultimately eliminate MRSA from clinical settings. Thus, another method for the cytoxicity of MRSA is described by Von Eiff et al. They describe how S. Aureus can be killed in vitro by shock-waves. They also suggest osmolyte stimulation of innate anti-microbial defence systems and bacteriophhage therapy to eliminate the weaker strains of MRSA. Therefore, concentrate efforts on a narrower range of MRSA so MRSA as a whole is more likely to be significantly reduced if not eradicated completely.
Other alternatives to anti-biotics include surgery. This may be via thorough the excision of all infected tissue and bone (which is a compulsory procedure,) the management of dead space with “packing” or drains.
However, anti-biotics used in combination with surgery is often necessary for a more long-term “cure.” On-top of this the management of MRSA requires infection control, offloading, adequate vascularity, and meticulous wound care.
A surgical option could be through maggot therapy. This is the debridement of necrotic tissue with sterile fly larvae and clinical trials suggest it is very effective in relation to MRSA. Maggots can provide a cost-effective alternative to conventional treatments, but the therapy become very unpopular with the introduction of antibiotics. However, with the treatment of chronic wounds infected with antibiotic-resistant bacteria such as MRSA "maggots are often successful where conventional remedies have failed" says Dr. Sherman.
The maggots move over the surface of a fine nylon net which is placed over the wound and secrete a proteolytic enzymes to break down dead tissue which they then ingest.
Additional alternatives include creams and shampoos may also be used. This may be for pets as well as the patient, because domestic animals may carry the MRSA in their coats and transmit it to those who are vulnerable. New research has found a compound that occurs naturally in garlic called allicin and this has been developed into a cream for people with MRSA. It is highly effective against MRSA and can be applied to the skin and nostrils.
A new nasal spray has also been developed. It contains phages which when sprayed in the nose or even work surfaces kill MRSA.
Assuming the infection is around a sore, further alternatives to antibiotics include draining the sore. The Government has emphasised that hospitals should use less antibiotics to limit the opportunity for bacteria to develop resistance (opportunistic.)