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Letter to the Editor

Editor, – We read with interest the article Community acquired methicillin-resistant Staphylococcus aureus infection' (Aust Prescr 2005;28:155). In a developing country like India, a significant number of methicillin-resistant Staphylococcus aureus (MRSA) infections are being acquired from the community.1 We need to curtail infection as quickly as possible and alter any long established practices which may be enhancing the development and spread of MRSA.2

The major problem is the inappropriate use of antibiotics. Given the increasing ecological pressure of antibiotics globally, bacteria respond by becoming resistant. Faced with the established scientific evidence of a relationship between antimicrobial use and MRSA prevalence, we suggest restricting the use of certain antimicrobial classes as an adjunct to infection control practices, which should be reinforced to fight MRSA in hospitals. The prescribing that led to the selection of MRSA can be identified by studying local retrospective data.

Basic hygiene is also important in the continued fight against pathogens.3 One needs to consider the epidemiological and physical properties of staphylococci, and each component of their transmission cycle between man and the environment. There is evidence to support hygienic measures at every stage.4

Gabriel Rodrigues
Associate Professor and Consultant Surgeon
Department of Surgery
Kasturba Medical College

Sohil Ahmed Khan
Lecturer and Clinical Pharmacist
Department of Pharmacy Practice
Manipal College of Pharmaceutical Sciences
Manipal, India


  1. Krishna BV, Patil AB, Chandrasekhar MR. Community-acquired methicillin-resistant Staphylococcus aureus infections in a south Indian city. Southeast Asian J Trop Med Public Health 2004;35:371-4.
  2. Spigelman M. MRSA - why treat the symptoms and not the disease? Ann R Coll Surg Engl 2005;87:452-3.
  3. Aiello AE, Larson EL. What is the evidence for a causal link between hygiene and infections? Lancet Infect Dis 2002;2:103-10.
  4. Dancer SJ. How do we assess hospital cleaning? A proposal for microbiological standards for surface hygiene in hospitals. J Hosp Infect 2004;56:10-5.