Rethinking Combination Therapy for S. aureus bacteremia: A Fading Paradigm

New Microbiol. 2024 Jul;47(2):183-185.

Abstract

Staphylococcus aureus bacteremia presents clinical complexities, with prolonged duration associated with unfavorable outcomes. This research delves into unconventional treatments, such as combinations involving daptomycin, oxacillin, ceftaroline, and fosfomycin, with the aim of swiftly sterilizing bloodstream infection to reduce complications. Our examination of 30 MSSA bacteremia patients with infective endocarditis uncovers differing results between single-agent therapies (oxacillin or daptomycin) and combined treatment plans. Microbiologic clearance at the 72 hour mark demonstrates greater efficacy within the combination cohort (bacteremia persistence 29%) versus monotherapy (bacteremia persistence 78%). This limited case series suggests the potential superiority of combination therapy, prompting further investigations.

Keywords: Bacteremia; Staphylococcus aureus; combination therapy; endocarditis; monotherapy.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Bacteremia* / drug therapy
  • Bacteremia* / microbiology
  • Daptomycin / administration & dosage
  • Daptomycin / therapeutic use
  • Drug Therapy, Combination*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Staphylococcal Infections* / drug therapy
  • Staphylococcal Infections* / microbiology
  • Staphylococcus aureus* / drug effects

Substances

  • Anti-Bacterial Agents
  • Daptomycin