scholarly journals Pilot Study of Aerosolised Plus Intravenous Vancomycin in Mechanically Ventilated Patients with Methicillin-Resistant Staphylococcus Aureus Pneumonia

2020 ◽  
Vol 9 (2) ◽  
pp. 476 ◽  
Author(s):  
Jun Yeun Cho ◽  
Hyung-Sook Kim ◽  
Hye-Joo Yang ◽  
Yeon Joo Lee ◽  
Jong Sun Park ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Mechanical Ventilation ◽  
Pilot Study ◽  
Clinical Cure ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Treatment Success ◽  
Lavage Fluid ◽  
Methicillin Resistant ◽  
Administration Time ◽  
Staphylococcus Aureus Pneumonia

Treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in critically ill patients remains unsatisfactory. This pilot study aimed to evaluate the clinical outcomes of aerosolised vancomycin in addition to intravenous administration in this setting. This was a prospective, noncomparative, phase II trial. Patients receiving mechanical ventilation for >48 h in intensive care units (ICUs) were screened; those receiving intravenous vancomycin for MRSA pneumonia were enrolled. Patients received aerosolised vancomycin (250 mg every 12 h for five days) via a vibrating mesh nebuliser. The primary outcome was treatment success (clinical cure or improvement) at the conclusion of antibiotic treatment. Vancomycin concentrations were measured in bronchoalveolar lavage fluid according to administration time. Twenty patients were enrolled (median age 75 years and 13 (65%) men; 18 (90%) cases with nosocomial pneumonia). Thirteen patients (65%) showed clinical cure or improvement. Microbiological eradication of MRSA was confirmed in 14 patients (70%). ICU and hospital mortality rates were 30% and 35%, respectively. Maximum aerosolised vancomycin concentration was observed 4–5 h after nebulising (98.75 ± 21.79 mcg/mL). No additional systemic adverse effects occurred following aerosol vancomycin treatment. Aerosolised vancomycin combination therapy may be an alternative treatment for patients with severe MRSA pneumonia receiving mechanical ventilation (ClinicalTrials.gov number, NCT01925066).

Role of interleukin-17 in a murine community-associated methicillin-resistant Staphylococcus aureus pneumonia model

2019 ◽  
Vol 21 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Yasushi Shibue ◽  
Soichiro Kimura ◽  
Chiaki Kajiwara ◽  
Yoichiro Iwakura ◽  
Keizo Yamaguchi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Interleukin 17 ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Pneumonia

scholarly journals Ceftaroline Desensitization Procedure in a Pregnant Patient With Multiple Drug Allergies

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
James L. Kuhlen ◽  
Kimberly G. Blumenthal ◽  
Caroline L. Sokol ◽  
Diana S. Balekian ◽  
Ana A. Weil ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Skin Testing ◽  
Pregnant Patient ◽  
Cross Reactivity ◽  
Multiple Drug ◽  
Methicillin Resistant ◽  
The Cross ◽  
Staphylococcus Aureus Pneumonia

Abstract Validated skin testing is lacking for many drugs, including ceftaroline. The cross-reactivity between ceftaroline and other β-lactam antibiotics is unknown. We report a case of a pregnant patient with cystic fibrosis and multiple drug allergies who required ceftaroline for methicillin-resistant Staphylococcus aureus pneumonia and underwent an uncomplicated empiric desensitization procedure.

scholarly journals Daptomycin Plus Fosfomycin Versus Daptomycin Alone for Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Miquel Pujol ◽  
José-María Miró ◽  
Evelyn Shaw ◽  
Jose-María Aguado ◽  
Rafael San-Juan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Staphylococcus Aureus ◽  
Adverse Events ◽  
Primary Endpoint ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Statistical Significance ◽  
Treatment Success ◽  
Open Label ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia

Abstract Background We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis. Methods A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy. Results Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93–1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018). Conclusions Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events. Clinical Trials Registration NCT01898338.

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