title: High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: case report.
abstract: BACKGROUND
  Emergence of daptomycin-nonsusceptible (DNS) Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus.
  
  
  METHODS
  We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD) device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin.
  
  
  CONCLUSIONS
  Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.
authors: Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Liang-Yu
authors: LY
authors: Chen
authors: Cheng-Hsiung
authors: CH
authors: Huang
authors: Shu-Chen
authors: SC
authors: Kuo
authors: Chen-Yuan
authors: CY
authors: Hsiao
authors: Mei-Lin
authors: ML
authors: Lin
authors: Fu-Der
authors: FD
authors: Wang
authors: Chang-Phone
authors: CP
authors: Fung
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