Prosthetic valve endocarditis due to methicillin-resistant Staphylococcus epidermidis and Micrococcus species successfully treated with rifampicin combined with other antibiotics.
Two patients with prosthetic valve endocarditis due to methicillin-resistant Gram-positive cocci (Staphylococcus epidermidis and Micrococcus spp.) are described. They were successfully treated with rifampicin combined first with an aminoglycoside and later with co-trimoxazole or co-trimoxazole plus vancomycin. The addition of rifampicin to these antibiotics resulted in enhanced serum bactericidal activity. High doses of rifampicin (1200-1800 mg) for 7-8 weeks did not cause any serious side-effect. Surgery was not required. During surveillance for more than 2 years endocarditis did not recur.
D000328:Adult; D000617:Aminoglycosides / Q000627:therapeutic use; D004338:Drug Combinations / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D008837:Micrococcus / Q000187:drug effects; D008875:Middle Aged; D010403:Penicillin Resistance; D012293:Rifampin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013212:Staphylococcus epidermidis / Q000187:drug effects; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014640:Vancomycin / Q000627:therapeutic use
D000617:Aminoglycosides; D004338:Drug Combinations; D014640:Vancomycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D008712:Methicillin; D012293:Rifampin