Cefazolin and Ertapenem Salvage Therapy Rapidly Clears Persistent Methicillin-Susceptible Staphylococcus aureus Bacteremia

被引：29
|
作者：
Ulloa, Erlinda R. [1 ,2 ]
Singh, Kavindra, V [3 ,4 ]
Geriak, Matthew [5 ]
Haddad, Fadi [6 ]
Murray, Barbara E. [3 ,4 ]
Nizet, Victor [1 ,7 ]
Sakoulas, George [1 ,5 ]
机构：
[1] Univ Calif San Diego, Sch Med, Dept Pediat, Collaborat Halt Antibiot Resistant Microbes, La Jolla, CA 92093 USA
[2] Childrens Hosp Philadelphia, Dept Pediat, Div Infect Dis, Philadelphia, PA 19104 USA
[3] Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, Dept Internal Med, Div Infect Dis, Houston, TX 77030 USA
[4] Univ Texas Hlth Sci Ctr Houston, Ctr Antimicrobial Resistance & Microbial Genom, McGovern Med Sch, Houston, TX 77030 USA
[5] Sharp Mem Hosp & Rehabil Ctr, San Diego, CA USA
[6] Sharp Grossmont Hosp, La Mesa, CA USA
[7] Univ Calif San Diego, Skaggs Sch Pharm, La Jolla, CA 92093 USA
来源：
CLINICAL INFECTIOUS DISEASES | 2020年 / 71卷 / 06期
基金：
美国国家卫生研究院;
关键词：
Staphylococcus aureus; bacteremia; endocarditis; cefazolin; ertapenem; PENICILLIN-BINDING PROTEINS; ENDOCARDITIS; MANAGEMENT; OXACILLIN; SYNERGY;
D O I：
10.1093/cid/ciz995
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Cefazolin and ertapenem combination therapy was used successfully to salvage 11 cases (6 endocarditis) of persistent methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, including immediate clearance (<= 24 hours) in 8 cases. While in vitro synergy was modest, cefazolin plus ertapenem exhibited synergistic action in a rat model of MSSA endocarditis. The combination of cefazolin and ertapenem provides potent in vivo activity against MSSA beyond what is predicted in vitro and warrants further clinical study in the treatment of refractory MSSA bacteremia and endocarditis. Cefazolin and ertapenem combination therapy yielded profound clinical success in 11 severe methicillin-susceptible Staphylococcus aureus infections with high bacterial densities (6 endocarditis), as demonstrated by rapid bacteremia clearance. Enhanced efficacy was also observed in a rat endocarditis model.
引用
收藏
页码：1413 / 1418
页数：6
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