Counterpoint: Vancomycin and Staphylococcus aureus--an antibiotic enters obsolescence.
The efficacy of vancomycin for the treatment of patients with infections due to Staphylococcus aureus is impaired by its poor tissue penetration and by its relatively weak antibacterial activity--an activity that is declining as S. aureus evolves. Neither dose escalation nor use of vancomycin in combination with other antibiotics that have antistaphylcoccal activity has been demonstrated to safely enhance its therapeutic efficacy. Although no clinical trials suggest superiority of vancomycin over any comparator, some have provided evidence of its inferiority. Strong consideration should be given to the use of alternative agents in the treatment of serious S. aureus infections.
Deresinski
Stan
S
Division of Infectious Disease and Geographic Medicine, Department of Medicine, Stanford University, CA, USA. polishmd@stanford.edu
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D019143:Evolution, Molecular; D006801:Humans; D016106:Methicillin Resistance / Q000187:drug effects; D008826:Microbial Sensitivity Tests / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D014640:Vancomycin