Ceftaroline and gentamicin for the treatment of daptomycin‐non‐susceptible meticillin‐resistant Staphylococcus aureus bacteraemia and endocarditis in a pregnant patient
| Autor: | Jose Menajovsky, Nathan R. Unger, Robert M. Richardson, Olayemi O. Osiyemi, Jennifer Kuretski |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty business.industry Hepatitis C biochemical phenomena metabolism and nutrition bacterial infections and mycoses medicine.disease_cause medicine.disease Microbiology Surgery Staphylococcus aureus Internal medicine Medicine Vancomycin Endocarditis Gentamicin Daptomycin business Adverse effect Abscess medicine.drug |
| Zdroj: | JMM Case Reports. 1 |
| ISSN: | 2053-3721 |
| Popis: | Introduction: Vancomycin remains the mainstay in the treatment of meticillin‐resistant Staphylococcus aureus (MRSA) bacteraemia; however, concerns exist about its continued efficacy in the presence of rising MICs. Daptomycin serves as an alternative but has also witnessed increases in reduced susceptibility. Several published case reports have demonstrated the potential utility of ceftaroline as a viable therapeutic option for invasive MRSA infections, including endocarditis. Case presentation: A 23‐year‐old pregnant female presented with complaints of foot pain and fevers up to 104 °F. Her past medical history included polysubstance abuse, hepatitis C, intravenous drug use and a right arm abscess 2 years ago due to MRSA. Daptomycin was started empirically due to an allergy (angioedema) to vancomycin. Blood cultures returned positive for MRSA and remained persistently positive for 10 days at which point ceftaroline was added. Subsequent positive blood cultures on day 12 revealed daptomycin‐non‐susceptible MRSA at an MIC of 4 µg ml–1. Consequently, daptomycin was discontinued and gentamicin was added. Blood cultures were negative by day 14 and the patient completed a total of 2 weeks of gentamicin and 4 weeks of ceftaroline after the first negative blood culture. The baby was born premature at 34 weeks and 2 days due to complications of pregnancy; however, no adverse effects of antimicrobial therapy were noted. Conclusion: We describe the emergence of daptomycin‐non‐susceptibility during treatment and the successful eradication of persistent daptomycin‐non‐susceptible MRSA bacteraemia and endocarditis with a combination of ceftaroline and gentamicin in a pregnant female. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|