Synercid plus vancomycin for the treatment of severe methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci infections: evaluation of 5 cases.
Synercid (quinupristin/dalfopristin), the first semi-synthetic injectable streptogramin, is a promising alternative to glycopeptides against many Gram-positive multiresistant bacteria. Vancomycin is still considered an effective agent for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections but therapeutic failures with glycopeptides have been observed, even for the treatment of infections caused by S. aureus strains sensitive to vancomycin. Synercid, in combination with a glycopeptide, may address this problem without causing significant side effects due to the different toxicity patterns of the 2 antimicrobials. This study reports our experience with the combination of Synercid and vancomycin in 5 patients with severe infection caused by MRSA or methicillin-resistant coagulase-negative Staphylococcus.
Sgarabotto
Dino
D
Departments of Infectious Diseases, Padua General and Teaching Hospital, Italy. sgara@unipd.it
Cusinato
Riccardo
R
Narne
Elena
E
Scano
Fabio
F
Zignol
Matteo
M
Gambino
Antonio
A
Cattelan
Annamaria
A
Meneghetti
Francesco
F
Cadrobbi
Paolo
P
D018784:Abdominal Abscess / Q000382:microbiology; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003030:Coagulase / Q000172:deficiency*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D004696:Endocarditis / Q000382:microbiology; D005260:Female; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000382:microbiology; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000201:enzymology; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use*; D014769:Virginiamycin / Q000009:adverse effects / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D003030:Coagulase; D014769:Virginiamycin; C062940:quinupristin-dalfopristin; D014640:Vancomycin; D008712:Methicillin