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    Shorr Score for MRSA Pneumonia

    Identifies pneumonia patients at low risk for MRSA.
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    When to Use
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    Why Use

    Patients >18 years old admitted for pneumonia.

    • The Shorr Score for MRSA Pneumonia was developed to assess risk of MRSA pneumonia in admitted patients for whom the reason for admission was pneumonia, in order to determine who might benefit from adding MRSA coverage.
    • Developed specifically to risk-stratify MRSA pneumonia patients, compared to the original health care associated pneumonia (HCAP) definition.
    • Also differentiates between MRSA and drug-resistant gram-negative pneumonia, which HCAP does not.
    • Pneumonia etiology varies for patients admitted for the diagnosis. Previous HCAP definition does not differentiate between drug resistant pathogens such as MRSA and other gram negative bacteria, which have different risk factors and treatments.
    • Can help reduce overtreatment of MRSA pneumonia.
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    Result:

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    Advice

    • Risk factors for MRSA (infection with MRSA in the past year, known colonization, necrotizing or cavitary pneumonia, high severity-of-illness scores e.g. PSI/PORT or APACHE II, preceding or concurrent influenza), should also be taken into account when deciding if MRSA treatment is warranted.
    • Intended to guide the decision of MRSA treatment initiation. Confirmation studies and clinical judgment should be used to decide if continued MRSA treatment is needed.

    Management

    Options for MRSA treatment include vancomycin, linezolid, and clindamycin.

    Content Contributors
    • Elias Wan, MD
    About the Creator
    Dr. Andrew Shorr
    Content Contributors
    • Elias Wan, MD