Successful treatment of persistent MRSA bacteremia using high-dose daptomycin combined with rifampicin.

Published on Jan 1, 2014in Internal Medicine1.005
· DOI :10.2169/INTERNALMEDICINE.53.2711
Hideharu Hagiya13
Estimated H-index: 13
(Okayama University),
Tomohiro Terasaka10
Estimated H-index: 10
(Okayama University)
+ 5 AuthorsFumio Otsuka35
Estimated H-index: 35
(Okayama University)
Sources
Abstract
We herein report a case of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that was successfully treated with combination therapy consisting of high-dose daptomycin (DAP, 10 mg/kg) and rifampicin. The patient's condition was complicated with multiple infectious foci, including an iliopsoas abscess and epidural abscess, as well as discitis and spondylitis at the cervical, thoracic and lumbar levels. Monotherapy treatments with vancomycin, linezolid and usual-dose DAP were all ineffective. It has been shown that usual-dose DAP administration may result in the emergence of a resistant strain and treatment failure. We would like to emphasize the importance of high-dose DAP therapy for MRSA bacteremia, a condition with a potentially high mortality rate.
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Abstract Evidence-based guidelines for the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). The guidelines are intended for use by health care providers who care for adult and pediatric patients with MRSA infections. The guidelines discuss the management of a variety of clinical syndromes associated with MRSA disease, including skin and soft tissue infections (SSTI), ba...
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Daptomycin is an important drug used in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection. A high dose of daptomycin is indicated for an MRSA infection with a minimum inhibitory concentration (MIC) of 1 mg/L for daptomycin. Combination therapies with daptomycin and other antimicrobial agents, including fosfomycin, display in vitro synergism potentially. This study was conducted to investigate the in vitro synergistic effect of daptomycin-based combination therapy agai...
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WHAT IS KNOWN AND OBJECTIVE: Treatment of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia is a long-standing challenge to health care, often complicated by metastatic infections, treatment failure and mortality. When MRSA bacteraemia persists despite adequate initial treatment, current Infectious Diseases Society of America guidelines recommend evaluation and removal of possible sources of infection. In addition, a change in therapy may be considered. The objective of this review ...
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Anerkannte Behandlungsmethoden der Spondylodiszitis sind Ruhigstellung und systemische Antibiose. Allerdings ist die Datenlage fur spezifische und weiterfuhrende Behandlungsempfehlungen sehr heterogen. Ziel dieser Ubersichtsarbeit ist die Therapieoptimierung der Spondylodiszitis anhand einer behandlungspfadorientierten Schweregradeinteilung im Konsens mit aktuellen Empfehlungen. Vom 1. 10. 1998 bis zum 31. 12. 2013 erfolgte die Etablierung einer Schweregradeinteilung mit spezifischen Therapieopt...
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#1Nancy SandovalH-Index: 1
#2Santiago GrauH-Index: 25
Last. Juan Pablo HorcajadaH-Index: 54
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ABSTRACT Aim: We reviewed the clinical use of daptomycin in daily practice. Materials & methods: Efficacy and safety were assessed in 175 consecutive patients given daptomycin for at least 72 h. Results: Daptomycin was given as rescue treatment in 50.9% of cases. Bloodstream infection (34.8%) and skin/soft-tissue infection (19.4%) were the most frequent. In 62.3% of patients, the dose of ≤ 6 mg/kg/day was administered. Staphylococcus spp. were isolated in 52.6% of cases (MRSA in 9.5%, CoNS in 34...
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