High-dose daptomycin plus fosfomycin is safe and effective in treating methicillin-susceptible and methicillin-resistant Staphylococcus aureus endocarditis.
We describe 3 patients with left-sided staphylococcal endocarditis (1 with methicillin-susceptible Staphylococcus aureus [MSSA] prosthetic aortic valve endocarditis and 2 with methicillin-resistant S. aureus [MRSA] native-valve endocarditis) who were successfully treated with high-dose intravenous daptomycin (10 mg/kg/day) plus fosfomycin (2 g every 6 h) for 6 weeks. This combination was tested in vitro against 7 MSSA, 5 MRSA, and 2 intermediately glycopeptide-resistant S. aureus isolates and proved to be synergistic against 11 (79%) strains and bactericidal against 8 (57%) strains. This combination deserves further clinical study.
Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain. jmmiro@ub.edu
José M
JM
Miró
José M
JM
Entenza
Ana
A
Del Río
Maria
M
Velasco
Ximena
X
Castañeda
Cristina
C
Garcia de la Mària
Marlyse
M
Giddey
Yolanda
Y
Armero
Juan M
JM
Pericàs
Carlos
C
Cervera
Carlos A
CA
Mestres
Manuel
M
Almela
Carlos
C
Falces
Francesc
F
Marco
Philippe
P
Moreillon
Asuncion
A
Moreno
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D017576:Daptomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D005260:Female; D005578:Fosfomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D017576:Daptomycin