title: Daptomycin-nonsusceptible vancomycin-intermediate staphylococcus aureus vertebral osteomyelitis cases complicated by bacteremia treated with high-dose daptomycin and trimethoprim-sulfamethoxazole.
abstract: We report two cases of daptomycin (DAP)-nonsusceptible (DNS) vancomycin-intermediate Staphylococcus aureus (VISA) vertebral osteomyelitis cases complicated by bacteremia treated with high-dose daptomycin and trimethoprim-sulfamethoxazole. Both patients responded rapidly and favorably to this combination. The clinical isolates from the two patients were tested post hoc in an in vitro pharmacokinetic/pharmacodynamic (PK/PD) model to confirm the bactericidal activity and enhancement of daptomycin and trimethoprim-sulfamethoxazole. The combination of high-dose daptomycin and trimethoprim-sulfamethoxazole should be explored further for the treatment of DNS VISA strains.
authors.affiliation: Wegman's School of Pharmacy, St. John Fisher College, Rochester, New York, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Avery
authors.forename: Molly E
authors.initials: ME
authors.lastname: Steed
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Woodruff
authors.forename: Muhammad
authors.initials: M
authors.lastname: Hasan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rybak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D017576:Daptomycin / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013131:Spine / Q000187:drug effects / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology / Q000627:therapeutic use*; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D017576:Daptomycin