BMC Infectious Diseases (May 2011)

High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible <it>Staphylococcus aureus</it>: Case report

  • Hsiao Chen-Yuan,
  • Kuo Shu-Chen,
  • Huang Cheng-Hsiung,
  • Chen Liang-Yu,
  • Lin Mei-Lin,
  • Wang Fu-Der,
  • Fung Chang-Phone

DOI
https://doi.org/10.1186/1471-2334-11-152
Journal volume & issue
Vol. 11, no. 1
p. 152

Abstract

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Abstract Background Emergence of daptomycin-nonsusceptible (DNS) Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus. Case presentation We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD) device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin. Conclusions Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.

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