Key result
Combination therapy with high-dose daptomycin and fosfomycin, alongside surgical device removal, successfully treated endocarditis and osteomyelitis caused by daptomycin-nonsusceptible MRSA.
Why the study?
Does combination therapy with high-dose daptomycin and fosfomycin along with surgical removal of the device improve outcomes in a patient with ICD-related endocarditis caused by daptomycin-nonsusceptible S. aureus?
Case Report (n=1)
No
Does combination therapy with high-dose daptomycin and fosfomycin along with surgical removal of the device improve outcomes in a patient with ICD-related endocarditis caused by daptomycin-nonsusceptible S. aureus?
Combination therapy with high-dose daptomycin and fosfomycin, along with device removal, may be effective for treating ICD-related endocarditis caused by daptomycin-nonsusceptible S. aureus.
May support combination therapy for refractory daptomycin-nonsusceptible MRSA endocarditis; hypothesis-generating and leaves open need for prospective trials.
BACKGROUND: Emergence of daptomycin-nonsusceptible (DNS) Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus. CASE PRESENTATION: We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD) device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin. CONCLUSIONS: Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2011) conducted a case report in ICD device-related endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus (n=1). High-dose daptomycin and fosfomycin was evaluated on Resolution of infection. Combination therapy with high-dose daptomycin and fosfomycin, alongside surgical device removal, successfully treated endocarditis and osteomyelitis caused by daptomycin-nonsusceptible MRSA.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: