Use of quinupristin/dalfopristin in a critical patient with a methicillin-resistant Staphilococcus aureus infection.

Abstract

The growing incidence of infections due to Gram-positive multiresistant germs has stimulated research into new drugs endowed with broader activity, that are useful in case of infections unresponsive to common antibiotics. The case of a 28-year-old man infected with a methicillin resistant Staphylococcus aureus non responder to therapy with glycopeptide antibiotics is reported. At admission the patient presented a septic condition and required mechanical ventilation. Antibiotic therapy was immediately started with teicoplanin+meropenem. Blood culture and bronchial aspirate evidenced a methicillin resistant Staphylococcus aureus with high sensibility to glycopeptide antibiotics. Although this therapy produced a slight improvement in clinical condition and the patient was extubated, fever and leucocytosis associated with a BAL positive to methicillin resistant Staphylococcus aureus, in vitro susceptible to glycopeptides, persisted. Considering the possibility of a non-responder condition of the patient to glycopeptide antibiotics, quinupristin/dalfopristin was added. The streptogramin produced a quick improvement in clinical condition with resolution of sepsis and culture sterilization. The patient improved progressively and was discharged. In conclusion, in our experience the association quinupristin/dalfopristin was effective in the resolution of a critical methicillin resistant Staphylococcus aureus infection non responder to classical treatment with glycopeptide antibiotics that showed a high sensibility in vitro.

• Authors: E De Robertis, D Viscidi, G Servillo, M Pezza, O Piazza, C A Giuliano, R Tufano
• Journal: Minerva anestesiologica (Minerva Anestesiol) Vol. 70 Issue 10 Pg. 747-9; 749-51 (Oct 2004) ISSN: 0375-9393 [Print] Italy
• PMID: 15516886 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Virginiamycin
• quinupristin

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Critical Illness
• Humans
• Male
• Methicillin Resistance
• Staphylococcal Infections (drug therapy, etiology, microbiology)
• Thoracic Injuries (complications, diagnostic imaging)
• Tomography, X-Ray Computed
• Virginiamycin (analogs & derivatives, therapeutic use)
• Wounds, Stab (complications, diagnostic imaging)