scholarly journals Ceftaroline as Salvage Therapy for Complicated Methicillin-Resistant Staphylococcus aureus Bloodstream Infections: Case Series and Analysis

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Charles Liu ◽  
Brandon Imp ◽  
Ranita Sharma ◽  
Tanaya Bhowmick
Keyword(s):  
Staphylococcus Aureus ◽  
Salvage Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Series ◽  
Bloodstream Infections ◽  
Methicillin Resistant

scholarly journals Vancomycin plus nafcillin salvage for the treatment of persistent methicillin-resistant Staphylococcus aureus bacteremia following daptomycin failure: a case report and literature review

2018 ◽  
Vol 6 ◽  
pp. 204993611879740
Author(s):  
Paul O. Lewis ◽  
Regan E. Sevinsky ◽  
Paras D. Patel ◽  
Matthew R. Krolikowski ◽  
David B. Cluck
Keyword(s):  
Staphylococcus Aureus ◽  
Case Report ◽  
Combination Therapy ◽  
Salvage Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Reports ◽  
Case Series ◽  
Blood Cultures ◽  
Beta Lactam ◽  
Methicillin Resistant

Background: Evidence supporting beta-lactam plus vancomycin synergy for methicillin-resistant Staphylococcus aureus (MRSA) continues to grow. Current in vivo evidence demonstrates that combination therapy is associated with shorter time to blood sterilization than vancomycin monotherapy. However, this combination has not been reported as salvage therapy for persistent MRSA bacteremia. Case report: We report a case of an 81-year-old male who was successfully treated with vancomycin plus nafcillin after failing vancomycin monotherapy, daptomycin monotherapy, and daptomycin plus gentamicin combination therapy. The patient originally presented with sepsis from a suspected urinary tract infection. Blood cultures drawn on days 1, 3, 5, 15, 19, 23, and 28 remained positive for MRSA despite multiple antimicrobial therapy changes. On day 29, therapy was changed to vancomycin plus nafcillin. Blood cultures drawn on day 32 remained negative. After 11 days, nafcillin was changed to piperacillin–tazobactam due to an infected decubitus ulcer. The combination was continued for 42 days after achieving blood sterility, 71 days after the patient originally presented. Evidence regarding salvage therapy for persistent bacteremia is sparse and is limited to case reports and case series. Conclusion: This case report supports that vancomycin plus an anti-staphylococcal beta-lactam combination should be further studied as salvage therapy for persistent MRSA bacteremia.

scholarly journals Antibiotic Resistance, spa Typing and Clonal Analysis of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Blood of Patients Hospitalized in the Czech Republic

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 395
Author(s):  
Katarina Pomorska ◽  
Vladislav Jakubu ◽  
Lucia Malisova ◽  
Marta Fridrichova ◽  
Martin Musilek ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Czech Republic ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bloodstream Infections ◽  
Spa Typing ◽  
The Czech Republic ◽  
Methicillin Resistant ◽  
Mrsa Strains ◽  
Spa Types ◽  
Repeat Pattern

Staphylococcus aureus is one of the major causes of bloodstream infections. The aim of our study was to characterize methicillin-resistant Staphylococcus aureus (MRSA) isolates from blood of patients hospitalized in the Czech Republic between 2016 and 2018. All MRSA strains were tested for antibiotic susceptibility, analyzed by spa typing and clustered using a Based Upon Repeat Pattern (BURP) algorithm. The representative isolates of the four most common spa types and representative isolates of all spa clonal complexes were further typed by multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing. The majority of MRSA strains were resistant to ciprofloxacin (94%), erythromycin (95.5%) and clindamycin (95.6%). Among the 618 strains analyzed, 52 different spa types were detected. BURP analysis divided them into six different clusters. The most common spa types were t003, t586, t014 and t002, all belonging to the CC5 (clonal complex). CC5 was the most abundant MLST CC of our study, comprising of 91.7% (n = 565) of spa-typeable isolates. Other CCs present in our study were CC398, CC22, CC8, CC45 and CC97. To our knowledge, this is the biggest nationwide study aimed at typing MRSA blood isolates from the Czech Republic.

scholarly journals 286. Exploratory Cost-Effectiveness Analysis for Treatment of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections: Are Daptomycin and Linezolid Favored over Vancomycin and Other Antibiotics?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S143-S144
Author(s):  
Michelle Vu ◽  
Kenneth Smith ◽  
Sherrie L Aspinall ◽  
Cornelius J Clancy ◽  
Deanna Buehrle
Keyword(s):  
Staphylococcus Aureus ◽  
Cost Effectiveness ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bloodstream Infections ◽  
Sensitivity Analyses ◽  
Drug Event ◽  
Base Case ◽  
Health Administration ◽  
Research Support ◽  
Methicillin Resistant

Abstract Background Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSAB) cause significant mortality and often require extended antibiotic therapy. Vancomycin, the most common initial MRSAB treatment, carries significant monitoring burden and nephrotoxicity risks. We compared cost-effectiveness of vancomycin and other antibiotic regimens as MRSAB treatment. Methods We estimated cost-effectiveness of intravenous antibiotics (vancomycin, daptomycin, linezolid, ceftaroline/daptomycin, dalbavancin) for Veterans Health Administration (VA) patients with MRSAB using an exploratory decision-tree model. Primary effectiveness outcome was composite of microbiological failure and adverse drug event (ADE)-related discontinuation at 7-days. Results In base-case analyses, linezolid and daptomycin were less expensive and had fewer treatment failures than other regimens at 4 and 6-weeks. Compared to linezolid, daptomycin incremental cost-effectiveness ratios were ~$45,000 (4-weeks) and ~$61,000 (6-weeks) per composite failure avoided, respectively. In one-way sensitivity analyses, daptomycin (4-weeks) was favored over linezolid if linezolid microbiological failure or ADE-related discontinuation rates were >14.8% (base case: 14.0%) or >14.3% (base case: 14.0%), respectively, assuming a willingness to pay (WTP) threshold of $40,000/ composite treatment failure avoided. Vancomycin was favored if its microbiological failure risk was < 16.4% (base case: 27.2%). In two-way sensitivity analyses, daptomycin was favored if linezolid microbiological failure and ADE-related discontinuation rates were >19% and > 16%, respectively. Linezolid, daptomycin and vancomycin were favored in 47%, 39%, and 11% of 4-week probabilistic iterations, respectively, at $40,000 WTP. Conclusion Daptomycin or linezolid are likely less expensive and more effective than vancomycin or other initial regimens for MRSAB. More data are needed to support safety of linezolid in MRSAB patients. Disclosures Cornelius J. Clancy, MD, Astellas (Consultant, Grant/Research Support)Cidara (Consultant, Research Grant or Support)Melinta (Grant/Research Support)Merck (Consultant, Grant/Research Support)Needham Associates (Consultant)Qpex (Consultant)Scynexis (Consultant)Shionogi (Consultant)

scholarly journals Case series of Community Acquired Methicillin Resistant Staphylococcus Aureus

2018 ◽  
Vol 73 ◽  
pp. 159
Author(s):  
S. Lupo ◽  
N. Tamagnone ◽  
M.S. Rodriguez ◽  
A. Co ◽  
M. Vera Blanch ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Series ◽  
Methicillin Resistant

scholarly journals Multicenter Cohort Study of Ceftaroline versus Daptomycin for Treatment of Methicillin-Resistant Staphylococcus aureus Bloodstream Infection

2021 ◽  
Author(s):  
Evan J Zasowski ◽  
Trang D Trinh ◽  
Kimberly C Claeys ◽  
Abdalhamid M Lagnf ◽  
Sahil Bhatia ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Treatment Failure ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Study Drug ◽  
Bloodstream Infections ◽  
Risk Difference ◽  
Multicenter Cohort Study ◽  
Methicillin Resistant ◽  
Composite Failure

Abstract Background Observational data suggest ceftaroline may be effective for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) but comparative data with standard of care are limited. This analysis compares the outcomes of MRSA BSI treated with ceftaroline or daptomycin. Methods Multicenter, retrospective, observational cohort study of adult patients with MRSA BSI from 2010 to 2017. Patients treated with ≥ 72 hours of ceftaroline or daptomycin were included. Those clearing BSI before study drug and those with a pneumonia source were excluded. The primary outcome was composite treatment failure, defined as 30-day mortality, BSI duration ≥ 7 days on study drug, and 60-day MRSA BSI recurrence. Inverse probability of treatment weighted risk difference in composite failure between daptomycin and ceftaroline groups was computed and 15% non-inferiority margin applied. Results Two hundred seventy patients were included; 83 ceftaroline and 187 daptomycin. Ceftaroline was non-inferior to daptomycin with respect to composite failure [39% daptomycin, 32.5% ceftaroline; weighted risk difference (95% CI) 7.0% (-5.0 – 19.0%)]. No differences between treatment groups was observed for 30-day mortality or other secondary efficacy outcomes. Creatine phosphokinase elevation was significantly more common among daptomycin patients (5.3% vs 0%, P = 0.034). Rash was significantly more common among ceftaroline patients (10.8 vs 1.1%, P = 0.001). Conclusions No difference in treatment failure or mortality was observed between MRSA BSI treated with ceftaroline or daptomycin. These data support future study of ceftaroline as a primary MRSA BSI treatment and current use of ceftaroline when an alternative to vancomycin and daptomycin is required.

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