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Vancomycin is one of the most commonly overused antibiotics in empiric therapy—especially in emergency departments and hospital wards. But does your patient really need MRSA coverage? In this video, we break down when empirical vancomycin is appropriate, how to assess true MRSA risk factors, and why overusing it can lead to serious harm—including nephrotoxicity and increased resistance. You’ll learn: • How MRSA epidemiology differs between the U.S. and Europe • The key questions to ask before starting vancomycin • When it’s safe to withhold vancomycin in empiric regimens • How to safely de-escalate with blood cultures and MRSA nasal PCR • Why better antibiotic decisions start with clinical reasoning, not fear FREE LESSONS: If you want a deeper, structured understanding of antibiotics, start with my free lessons on antibiotic fundamentals that take about an hour to complete: https://drviktorkotarski.podia.com/an... COMPLETE ONLINE COURSE: Then continue with the full course on hospital acquired infections, where I cover ESBLs, OXA-48, NDM, Pseudomonas, Acinetobacter, MRSA, VRE, and much more: https://drviktorkotarski.podia.com/ho... For short posts with extra clinical insights, follow me on LinkedIn. / viktor-kotarski-94922a63 DISCLAIMER: Please, always keep in mind that my videos are intended for educational purposes only. The content of my videos is NOT medical advice. I do not practice medicine over the Internet. If you are a patient and have any questions about your health, please talk to your doctor. CHAPTERS: 00:00 The main reason we include vancomycin in empiric therapy 00:34 Risk factors for MRSA 01:35 Community-acquired MRSA (CA-MRSA) 02:52 Crucial differences in MRSA epidemiology between Europe and the US 03:25 Three crucial questions to determine whether or not my patient needs vancomycin 03:59 What kinds of infections does S. aureus (including MRSA) cause? 06:01 When to safely discontinue vancomycin 06:50 Extra tip about MRSA pneumonia 07:18 Summary