Unsuccessful treatment of methicillin-resistant Staphylococcus aureus endocarditis with dalbavancin

J Clin Pharm Ther. 2018 Feb;43(1):101-103. doi: 10.1111/jcpt.12580. Epub 2017 Jun 19.

Abstract

What is known and objective: Limited evidence describes dalbavancin use in infective endocarditis (IE).

Case description: A 27-year-old pregnant female received 4 weeks of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and tricuspid valve IE after conventional therapy was no longer an option due to non-compliance. Despite having a smaller cardiac vegetation following dalbavancin, she was bacteraemic <2 weeks later with vancomycin-intermediate (VISA) and telavancin-non-susceptible S. aureus.

What is new and conclusion: This is the first report of unsuccessful IE treatment with dalbavancin. Blood cultures grew VISA and lipoglycopeptide-non-susceptible S. aureus <2 weeks following dalbavancin. Both outcomes raise concerns about using dalbavancin for IE.

Keywords: Staphylococcus aureus; MRSA; bacteremia; dalbavancin; endocarditis; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Endocarditis, Bacterial / drug therapy*
  • Female
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Staphylococcal Infections / drug therapy*
  • Teicoplanin / analogs & derivatives*
  • Teicoplanin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Teicoplanin
  • dalbavancin