Cefazolin and Ertapenem Salvage Therapy Rapidly Clears Persistent Methicillin-Susceptible Staphylococcus aureus Bacteremia. (27th November 2019)

• Record Type: Journal Article
• Authors: Ulloa, Erlinda R; Singh, Kavindra V; Geriak, Matthew; Haddad, Fadi; Murray, Barbara E; Nizet, Victor; Sakoulas, George
• Is Part Of: Clinical infectious diseases. Volume 71:Number 6(2020)
• Page Start: 1413
• Page End: 1418
• Publication Date: 2019-11-27
• Subjects: Staphylococcus aureus -- bacteremia -- endocarditis -- cefazolin -- ertapenem; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz995
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Cefazolin and ertapenem combination therapy was used successfully to salvage 11 cases (6 endocarditis) of persistent methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, including immediate clearance (≤24 hours) in 8 cases. While in vitro synergy was modest, cefazolin plus ertapenem exhibited synergistic action in a rat model of MSSA endocarditis. The combination of cefazolin and ertapenem provides potent in vivo activity against MSSA beyond what is predicted in vitro and warrants further clinical study in the treatment of refractory MSSA bacteremia and endocarditis. Abstract : Cefazolin and ertapenem combination therapy yielded profound clinical success in 11 severe methicillin-susceptible Staphylococcus aureus infections with high bacterial densities (6 endocarditis), as demonstrated by rapid bacteremia clearance. Enhanced efficacy was also observed in a rat endocarditis model.