Outbreaks of infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have been reported in incarcerated populations nationwide. The authors compared MRSA infection rates before and after the implementation of a standardized treatment guideline in the San Diego County jail system. This guideline included mandatory culturing, personal and environmental hygiene measures, standardized antibiotic treatments based on sensitivity patterns, and close surveillance of cases. The guideline reduced the proportion of soft tissue infections caused by MRSA (90.3% to 57.8%) and decreased the proportion of inmates diagnosed with MRSA after 10 days in custody. Documented resolution of the infection improved from 30.7% to 68.7% of cases. The average number of different antibiotic regimens per patient decreased from 3.06 to 1.78. The authors conclude that the guideline resulted in a decrease in MRSA transmission, fewer antibiotic courses, and improved resolution of cases.
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