Combination of quinupristin/dalfopristin and glycopeptide in severe methicillin-resistant staphylococcal infections failing previous glycopeptide regimens.
BACKGROUND
We report our experience with quinupristin/ dalfopristin in combination with a glycopeptide in the treatment of severe staphylococcal infections failing previous glycopeptide regimens.


METHODS
Five patients, affected by persistent bacteremia (n = 2), post-cardiothoracic surgery infection (n = 2) and post-traumatic bone infection (n = 1) due to methicillin-resistant Staphylococcus aureus (MRSA, n = 4) methicillin-resistant coagulase-negative Staphylococcus (MRCNS, n = 1) and unsuccessfully treated with antibiotics including a glycopeptide, were treated with a quinupristin/ dalfopristin and glycopeptide combination.


RESULTS
Three patients were clinically cured; one patient with MRSA thoracic aorta prosthetic infection relapsed after 3 months; one patient was lost to follow-up.


CONCLUSIONS
Quinupristin/dalfopristin, in combination with a glycopeptide, is an effective treatment option for severe methicillin-resistant staphylococcal infections failing previous glycopeptide regimens.
Dept. of Infectious Disease, Cà Foncello Regional Hospital, Treviso, Italy. pscotton@ulss.tv.it
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D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D015169:Colony Count, Microbial; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D017334:Teicoplanin / Q000494:pharmacology; D016896:Treatment Outcome; D014640:Vancomycin / Q000494:pharmacology; D014769:Virginiamycin / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D014769:Virginiamycin; C113825:quinupristin; D017334:Teicoplanin; D014640:Vancomycin; C113826:dalfopristin