Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most serious infections, often leading healthcare providers to start powerful, broad-spectrum antibiotics like intravenous (IV) vancomycin. While vancomycin can be life-saving, unnecessary use contributes to significant side effects and antimicrobial resistance.
In this Truveta experts spotlight, Nick Stucky, MD, PhD explores national trends in rapid MRSA diagnostic testing and IV vancomycin prescribing. Nick is a physician–scientist and VP of Research at Truveta. As a clinician and infectious disease researcher, he has focused on clinical decision support and point-of-care diagnostics. His analysis looks at testing changes over time nationally and then focuses on encounters with pneumonia to see how testing and treatment moved together in a high-relevance clinical setting.
Why it matters
A rapid diagnostic test can rule out MRSA infection quickly and help guide more precise prescribing. These tests can reduce unnecessary antibiotic exposure, thereby improving patient safety, and helping combat antimicrobial resistance. While MRSA testing has demonstrated utility in narrowing antibiotic use across several types of infections (2), the evidence is particularly robust for pneumonia (1,4), where it is explicitly recommended in clinical guidelines (3). Understanding testing trends sheds light on whether hospitals and clinicians are adopting this best-practice approach to improve care.
Methods
Using Truveta Data, Nick examined national trends in MRSA nasal swab testing from 2018 through 2024. Analyzing over 2.9 million nasal swab tests, he compared changes in testing rates to changes in the use of IV vancomycin to understand whether increased diagnostics have translated into reduced antibiotic prescribing.
He further focused on pneumonia patients, where guidelines strongly support rapid MRSA testing, to assess adoption in a high-relevance clinical context.
Results
Nationally, MRSA testing orders increased substantially from 2018–2024. and IV vancomycin use rose compared with 2018, indicating broader adoption of MRSA screening alongside continued use of anti-MRSA therapy.
- MRSA test orders increased substantially (101%) from 2018–2024.
- Despite increased testing, IV vancomycin use also rose nationally (128% over the same time period).
- Among pneumonia patients, uptake of MRSA testing increased more sharply (416% increase from 2018-2024) than vancomycin use (146% increase from 2018-2024), suggesting alignment with clinical guidance and impact on antibiotic administration.
How Truveta Data enabled this research
Truveta Data’s breadth and representativeness across health systems allowed Nick to track MRSA testing and antibiotic prescribing trends at both the national and state level. The ability to link laboratory diagnostics with medication data provided a complete view of adoption and its clinical impact—insights that would be difficult to capture using claims data alone.
Discussion
This analysis points to growing adoption of MRSA rapid testing across the US. Encouragingly, in conditions like pneumonia—where data and guidelines are strongest—uptake is higher, showing clinicians are increasingly integrating diagnostics into care for this population. However, rising IV vancomycin use despite more testing may highlight a gap between diagnostic capacity and prescribing practice, underscoring opportunities for stewardship and education.
These are preliminary research findings and not peer reviewed. Data are constantly changing and updating. These findings are consistent with data accessed September 2025.
Future research
Future work could explore whether increased MRSA testing leads to shorter durations of IV vancomycin therapy, or assess outcomes such as rates of nephrotoxicity or length of hospital stay. Additional research could also evaluate adoption across different hospital types (academic vs. community) and examine barriers to broader uptake.
See how Truveta Data can accelerate your next study—Request a customized demo today
About Truveta experts
The Truveta experts series highlights insights from researchers, clinicians, and data scientists working across Truveta. Each post highlights how real-world data can unlock new understanding—from disease patterns to treatment complexity to population health trends.
Explore more in this series:
Treatment trends for trigeminal neuralgia
Fireworks during the fourth of July
Real-world trends in Rituxan biosimilar adoption
Sudden cardiac arrest and arrhythmias among patients with chronic kidney disease
Biomarker testing trends in metastatic non-small cell lung cancer
Citations
- Dangerfield, Benjamin, et al. “Predictive value of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab PCR assay for MRSA pneumonia.” Antimicrobial agents and chemotherapy2 (2014): 859-864.
- Mergenhagen, Kari A., et al. “Determining the utility of methicillin-resistant Staphylococcus aureus nares screening in antimicrobial stewardship.” Clinical Infectious Diseases5 (2020): 1142-1148.
- Metlay, Joshua P., et al. “Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America.” American journal of respiratory and critical care medicine7 (2019): e45-e67.
- Parente, Diane M., et al. “The clinical utility of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening to rule out MRSA pneumonia: a diagnostic meta-analysis with antimicrobial stewardship implications.” Clinical Infectious Diseases1 (2018): 1-7.