title: Daptomycin and rifampin for the treatment of methicillin-resistant Staphylococcus aureus septic pulmonary emboli in the absence of endocarditis.
abstract: Daptomycin has demonstrated clinical efficacy in the treatment of methicillin-resistant Staphylococcus aureus-associated bacteremia and right-sided infective endocarditis. Although daptomycin is not approved for treatment of gram-positive pneumonia, clinical evidence suggests that it may be effective therapy for S. aureus-associated septic pulmonary emboli (SPE). We present our clinical experience with the use of daptomycin in combination with rifampin in four patients with SPE in the absence of infective endocarditis. Three of the patients had a history of injection drug use; two of these patients also had soft-tissue infections. All patients had clinical resolution of their infections. Daptomycin and rifampin appear to have a role in the treatment of methicillin-resistant S. aureus bacteremia with SPE in the absence of infective endocarditis and should be considered in patients that have failed therapy with vancomycin.
authors.affiliation: Division of Infectious Diseases, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07101, USA.
authors.forename: Eric O
authors.initials: EO
authors.lastname: Gomez
authors.forename: Ahmar
authors.initials: A
authors.lastname: Jafary
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Dever
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017576:Daptomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D011859:Radiography; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D018805:Sepsis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin; D012293:Rifampin