High-dose daptomycin plus fosfomycin is safe and effective in treating methicillin-susceptible and methicillin-resistant Staphylococcus aureus endocarditis.

Abstract

We describe 3 patients with left-sided staphylococcal endocarditis (1 with methicillin-susceptible Staphylococcus aureus [MSSA] prosthetic aortic valve endocarditis and 2 with methicillin-resistant S. aureus [MRSA] native-valve endocarditis) who were successfully treated with high-dose intravenous daptomycin (10 mg/kg/day) plus fosfomycin (2 g every 6 h) for 6 weeks. This combination was tested in vitro against 7 MSSA, 5 MRSA, and 2 intermediately glycopeptide-resistant S. aureus isolates and proved to be synergistic against 11 (79%) strains and bactericidal against 8 (57%) strains. This combination deserves further clinical study.

• Authors: José M Miró, José M Entenza, Ana Del Río, Maria Velasco, Ximena Castañeda, Cristina Garcia de la Mària, Marlyse Giddey, Yolanda Armero, Juan M Pericàs, Carlos Cervera, Carlos A Mestres, Manuel Almela, Carlos Falces, Francesc Marco, Philippe Moreillon, Asuncion Moreno, Hospital Clinic Experimental Endocarditis Study Group
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 56 Issue 8 Pg. 4511-5 (Aug 2012) ISSN: 1098-6596 [Electronic] United States
• PMID: 22644033 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Fosfomycin
• Daptomycin

Topics

• Aged
• Anti-Bacterial Agents (administration & dosage, adverse effects, therapeutic use)
• Daptomycin (administration & dosage, adverse effects, therapeutic use)
• Drug Synergism
• Drug Therapy, Combination
• Endocarditis, Bacterial (drug therapy)
• Female
• Fosfomycin (administration & dosage, adverse effects, therapeutic use)
• Humans
• Male
• Methicillin-Resistant Staphylococcus aureus (drug effects)
• Microbial Sensitivity Tests
• Middle Aged
• Staphylococcal Infections (drug therapy, microbiology)