Hi Linda, Staph Aureus has become so strong and resistant over the years of treatment, now there is MRSA, MSSA, and more to come.  I have always kept the communication lines wide open with the pharmacists I work with, asking all types of questions and they are so resourceful to us as nursing staff.  I have also heard over many years of the over use of antibiotics and the fact these super bugs are growing stronger every year and more and more infected patient’s and also the public, are driving antibiotic immunity to a scarce level. Now you may agree that VRE (Vancomycin Resistant Enterococcus) scares us all more than MRSA…lol..but true…  In the little ED I am working in right now I like to say to my co-workers, there is a sepsis craze going on around us and we laugh yet we get annoyed with the insane amount of blood cultures we draw and lactic acids we run… But the most common antibiotic we give is 1st line Zosyn, then Vancomycin and our pharmacy is sometimes slack getting us the medications on time and the vancomycin is often becomes the first dose we have to give, I would be asking that physician an awful lot of questions about why vancomycin??? And unfortunately they have almost no other choice but to administer it….on and on the medical field goes…

Vancomycin may be overused for the treatment of hospital-acquired pneumonia, perhaps because of physicians’ perceptions that patients are at high risk for methicillin-resistant Staphylococcus aureus (MRSA). The MRSA-culture-negative patients continued to receive vancomycin for a varying duration after the culture results were known (ICAAC, 2006).

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