title: Successful treatment of persistent MRSA bacteremia using high-dose daptomycin combined with rifampicin.
abstract: We herein report a case of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that was successfully treated with combination therapy consisting of high-dose daptomycin (DAP, 10 mg/kg) and rifampicin. The patient's condition was complicated with multiple infectious foci, including an iliopsoas abscess and epidural abscess, as well as discitis and spondylitis at the cervical, thoracic and lumbar levels. Monotherapy treatments with vancomycin, linezolid and usual-dose DAP were all ineffective. It has been shown that usual-dose DAP administration may result in the emergence of a resistant strain and treatment failure. We would like to emphasize the importance of high-dose DAP therapy for MRSA bacteremia, a condition with a potentially high mortality rate.
authors.affiliation: Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hagiya
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Terasaka
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kimura
authors.forename: Asuka
authors.initials: A
authors.lastname: Satou
authors.forename: Kikuko
authors.initials: K
authors.lastname: Asano
authors.forename: Koichi
authors.initials: K
authors.lastname: Waseda
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hanayama
authors.forename: Fumio
authors.initials: F
authors.lastname: Otsuka
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D017576:Daptomycin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D012293:Rifampin / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D017576:Daptomycin; D012293:Rifampin