The Cardiovascular
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Shorr Score for MRSA Pneumonia

Estimates MRSA risk in patients hospitalised with pneumonia.

Shorr Score for MRSA Pneumonia
Recent hospitalisation
ICU admission (this presentation)
Age <30 or >79 years
Prior IV antibiotic exposure
Dementia
Cerebrovascular disease
Female with diabetes mellitus
Recent nursing home / SNF / long-term acute care exposure
Result0 points

Low risk - MRSA prevalence under about 10%; empiric anti-MRSA cover may be unnecessary.

Shorr score
0 points

When to use

  • Deciding whether to add empiric MRSA coverage in a patient admitted with pneumonia.

Formula

Two points each for recent hospitalisation and ICU admission; one point each for age <30 or >79, prior IV antibiotics, dementia, cerebrovascular disease, female with diabetes, and recent nursing-home/long-term-care exposure. Range 0-10 (low 0-1, medium 2-5, high >=6).

Pearls and pitfalls

  • Designed chiefly to rule out MRSA at low scores and spare unnecessary vancomycin/linezolid.
  • Local MRSA prevalence should temper decisions at intermediate scores.

References

  1. Shorr AF, et al. BMC Infect Dis. 2013;13:268.