Clinical Research Directory

Inclusion Criteria: * Age \>= 18 years old * Patients admitted to Charleston Area Medical Center (CAMC) through the Emergency Department who meet the CDC criteria for pneumonia. * Nasal surveillance culture for MRSA obtained in the Emergency Department * Patients receiving vancomycin and additional antibiotic therapy for gram-negative coverage Exclusion Criteria: * Persistent vasopressor requirements when MRSA nasal swab results are available * Patients not meeting the CDC criteria for pneumonia * Patients presenting to the ED with leukopenia (≤4000) without previous documentation of normal or elevated WBC * Patients receiving empiric MRSA antibiotic therapy other than vancomycin for pneumonia * Patients with the diagnosis of lung abscess * Patients not receiving vancomycin therapy before MRSA nasal swab results are reported * Immunocompromised individuals. i.e. patients with AIDS/HIV, vasculitis on immune suppressor therapy, steroid therapy for more than one week prior admission or who received chemotherapy in the last 3 months * Patients who do not have a MRSA nasal swab obtained in the ED * Nares swab obtained after the completion of the first administered dose of an antibiotic with activity against MRSA * Patients with MRSA bacteremia * Patients with chronic tracheostomy