Treatment of high-level gentamicin-resistant Enterococcus faecalis endocarditis with daptomycin plus ceftaroline.

Abstract	A recurrent case of left-sided endocarditis caused by high-level aminoglycoside-resistant Enterococcus faecalis was successfully treated with ceftaroline and daptomycin. This combination demonstrated excellent synergy in vitro. Mechanistically, ceftaroline enhanced binding of daptomycin to the cell membrane and sensitized E. faecalis to killing by human cathelicidin LL-37, a cationic innate host defense peptide. Daptomycin plus ceftaroline may be considered in salvage therapy in E. faecalis endovascular infections and requires further study.
Authors	George Sakoulas, Poochit Nonejuie, Victor Nizet, Joseph Pogliano, Nancy Crum-Cianflone, Fadi Haddad
Journal	Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 57 Issue 8 Pg. 4042-5 (Aug 2013) ISSN: 1098-6596 [Electronic] United States
PMID	23689728 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References	Anti-Bacterial Agents Antimicrobial Cationic Peptides Cephalosporins Gentamicins Daptomycin Cathelicidins
Topics	Anti-Bacterial Agents (pharmacology) Antimicrobial Cationic Peptides (metabolism) Cell Membrane (drug effects) Cephalosporins (pharmacology) Daptomycin (pharmacology) Drug Resistance, Bacterial Drug Synergism Endocarditis, Bacterial (drug therapy) Enterococcus faecalis (drug effects, isolation & purification) Gentamicins (pharmacology) Humans Male Microbial Sensitivity Tests Middle Aged Cathelicidins Ceftaroline

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