Cost‐Effectiveness Analysis of Treatment of Methicillin‐ResistantStaphylococcus aureusBacteremia and Endocarditis Is a Difficult Issue

Methicillin-resistant Staphylococcus aureus (MRSA) was first detected in 1961. Today, MRSA is widely spread around the world. In the United States [1] and in many European countries, 25%–50% of S. aureus isolates are MRSA [2], even if some countries (eg, the Netherlands and the Scandinavian countries) have a low level of cases of invasive MRSA infection. Invasive MRSA infections, such as bacteremia and endocarditis, are difficult to treat because the treatment options are limited. MRSA bacteremia also has a higher mortality rate than does bacteremia due to methicillin-susceptible S. aureus (MSSA) [3]. Infective endocarditis due to MRSA has a trend toward a higher mortality rate compared with that due to MSSA [4]. Many of the patients are immunocompromised with underlying diseases and may have intracardiac devices or intravenous catheters in place, and such infections are difficult to treat without replacement of these devices.