Treatment of tricuspid valve endocarditis with daptomycin and linezolid therapy

Author:

Galanter Kayla M1,Ho Jackie2

Affiliation:

1. College of Pharmacy, Western University, Pomona, CA

2. Pharmacy, San Leandro Hospital, San Leandro, CA

Abstract

Abstract Purpose A case report of the use of linezolid and daptomycin for the treatment of multidrug-resistant right-sided infective endocarditis is presented. Summary A 36-year-old patient with a history of intravenous drug use was hospitalized for treatment of native tricuspid valve endocarditis resulting in persistent methicillin-resistant Staphylococcus aureus bacteremia. During the admission the patient was unsuccessfully treated with vancomycin monotherapy (final E-test minimum inhibitory concentration, 4 μg/mL). The patient’s treatment was switched to daptomycin and gentamicin, with no improvement in blood culture results over 4 days. Gentamicin was discontinued, and linezolid was administered in combination with daptomycin; bacteremia was cleared after 13 days of linezolid and daptomycin combination therapy. Due to daptomycin resistance (minimum inhibitory concentration, 4 μg/mL), gentamicin was substituted for daptomycin due to the former agent’s synergistic effects with linezolid. After 23 days of therapy the patient was transferred to another facility for a tricuspid valve replacement procedure, which was completed without complications. The patient was transferred in stable condition to a skilled nursing facility to continue antibiotic therapy lasting 6 weeks from the date of surgery. The patient’s blood cultures remained negative. Conclusion A 36-year-old woman with resistant tricuspid valve endocarditis was successfully treated with linezolid in combination with daptomycin.

Publisher

Oxford University Press (OUP)

Subject

Health Policy,Pharmacology

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4. Early oral switch to linezolid for low-risk patients with Staphylococcus aureus bloodstream infections: a propensity-matched cohort study;Willekens;Clin Infect Dis

5. Clinical relevance of bacteriostatic versus bactericidal mechanisms of action in the treatment of gram-positive bacterial infections;Pankey;Clin Infect Dis.,2004

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