As vancomycin should be kept as reserve drug, any other drug which can be used as an alternative. Is there any study about the aminoglycoside use and their clinical outcome for MRSA strains?
Due to toxicity, aminoglycosides should not be used on their own to treat systemic infections. UTI may be an exception. Vancomycin, daptomycin and linezolid are better options
some studies have shown that netilmicin , amikacin are having good (>90%) sensitivity pattern in invitro tests. But clinical outcome was not mentioned. If clinical outcome is good Netilmicin can also be used as alternative to vancomycin.
Datomycin ,linezolid also are higher antibiotics where resistance is emerging.
Regardless of susceptibility pattern, aminoglycosides are not considered the treatment of choice for staphylococcal infections. I am not aware of any studies on clinical outcomes with aminoglycosides as the primary antibiotic. Although they have been administered in combination with other antibiotics (primarily vancomycin and antistaphylococcal penicillins), the evidence does not support their use in face of similar clinical outcomes but higher toxicity (primarily nephrotoxicity).
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