Antimicrobial Management Strategies for Multidrug-Resistant Gram-Positive Prosthetic Device Infections.

Prosthetic device infections caused by multidrug-resistant (MDR) gram-positive bacteria pose significant therapeutic challenges. This review examines management strategies for methicillin-resistant staphylococci, ampicillin-resistant enterococci, vancomycin-resistant enterococci, and MDR Corynebacterium infections. Success requires coordinated surgical intervention and antimicrobial therapy, with device removal often necessary. Vancomycin remains the cornerstone for most resistant organisms, while newer agents like dalbavancin enable outpatient therapy. Critical considerations include recognizing linezolid toxicity during prolonged therapy, and understanding that surgical approach determines outcomes more than antimicrobial selection.