What do beta-lactams add to vancomycin or daptomycin in the treatment of patients with methicillin-resistant Staphylococcus aureus bacteraemia? A review
| Autor: | Julián Solís García del Pozo, Juan Carlos Segura Luque, Fernando Mateos Rodríguez, José Javier Blanch Sancho, Elisa Martínez Alfaro, Laura García Aragonés |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0303 health sciences
medicine.medical_specialty 030306 microbiology business.industry Cefepime General Medicine biochemical phenomena metabolism and nutrition bacterial infections and mycoses medicine.disease_cause Methicillin-resistant Staphylococcus aureus Tazobactam 03 medical and health sciences 0302 clinical medicine Cloxacillin Internal medicine polycyclic compounds medicine Vancomycin 030212 general & internal medicine Flucloxacillin Daptomycin business medicine.drug Piperacillin |
| Zdroj: | Postgraduate Medical Journal. 98:48-56 |
| ISSN: | 1469-0756 0032-5473 |
| DOI: | 10.1136/postgradmedj-2020-139512 |
| Popis: | Several studies have documented the synergy between vancomycin/daptomycin and various beta-lactams, and clinical studies have studied this combination therapy in humans. We review the published literature on this topic to know the utility of the combined treatment with beta-lactams in treating bacteraemia methicillin-resistant Staphylococcus aureus (MRSA) infections. Fifteen observational studies, three randomised clinical trials and three systematics reviews are analysed in this article. Observational studies used ceftaroline, cefazolin, piperacillin/tazobactam or cefepime among the beta-lactams. Clinical trials used cloxacillin or flucloxacillin as the most used beta-lactam in two trials and ceftaroline in one. Three systematic reviews are published. One of them only includes studies with vancomycin and included six studies. The other two systematic reviews include patients with daptomycin or vancomycin and included 15 and 9 studies, respectively. Adding a beta-lactam to vancomycin or daptomycin may help shorten bacteraemia and avoid recurrences in patients with MRSA bacteraemia. There is no evidence that combined therapy improves mortality. Nephrotoxicity in clinical trials precludes the use of combination therapy mainly with cloxacillin or flucloxacillin, but systematic reviews have not found a significant difference in this point in observational studies with other beta-lactams. The role of other beta-lactams such as ceftaroline should be thoroughly studied in these patients. |
| Databáze: | OpenAIRE |
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