Abstract
We describe 3 patients with left-sided staphylococcal endocarditis (1 with methicillin-susceptible Staphylococcus aureus [MSSA] prosthetic aortic valve endocarditis and 2 with methicillin-resistant S. aureus [MRSA] native-valve endocarditis) who were successfully treated with high-dose intravenous daptomycin (10 mg/kg/day) plus fosfomycin (2 g every 6 h) for 6 weeks. This combination was tested in vitro against 7 MSSA, 5 MRSA, and 2 intermediately glycopeptide-resistant S. aureus isolates and proved to be synergistic against 11 (79%) strains and bactericidal against 8 (57%) strains. This combination deserves further clinical study.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Anti-Bacterial Agents / administration & dosage*
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Anti-Bacterial Agents / adverse effects
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Anti-Bacterial Agents / therapeutic use
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Daptomycin / administration & dosage*
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Daptomycin / adverse effects
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Daptomycin / therapeutic use
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Drug Synergism
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Drug Therapy, Combination
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Endocarditis, Bacterial / drug therapy*
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Female
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Fosfomycin / administration & dosage*
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Fosfomycin / adverse effects
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Fosfomycin / therapeutic use
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Humans
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Male
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Methicillin-Resistant Staphylococcus aureus / drug effects*
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Microbial Sensitivity Tests
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Middle Aged
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Staphylococcal Infections / drug therapy*
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Staphylococcal Infections / microbiology
Substances
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Anti-Bacterial Agents
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Fosfomycin
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Daptomycin