Endocarditis due to vancomycin-resistant Enterococcus faecium in an immunocompromised patient: cure by administering combination therapy with quinupristin/dalfopristin and high-dose ampicillin.
A 56-year-old man with diabetes mellitus and cadaveric renal transplantation had vancomycin-resistant Enterococcus faecium tricuspid valve endocarditis. Relapse followed 6 weeks of treatment with intravenous gentamicin and high-dose ampicillin. On the basis of previous data suggesting the potential for synergistic activity of quinupristin/dalfopristin plus high-dose ampicillin, therapy with this combination was administered for 63 days. Cure was achieved and later confirmed at 2-year follow-up.
D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D016984:Enterococcus faecium; D005839:Gentamicins / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D012008:Recurrence; D016896:Treatment Outcome; D020713:Vancomycin Resistance; D014769:Virginiamycin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D010406:Penicillins; D014769:Virginiamycin; C113825:quinupristin; D000667:Ampicillin; C113826:dalfopristin