Vancomycin and Rifampin: A Synergistic Approach to the Eradication of a Staphylococcus Haemolyticus Bacteremia

Abstract

Objective: To report a case of Staphylococcus haemolyticus bacteremia that appeared unresponsive to vancomycin therapy alone but was successfully treated with the addition of rifampin therapy. Setting: Public, university, teaching hospital (University of Minnesota Hospital and Clinic, Minneapolis). Case Summary: A man with a history of bladder cancer developed S. haemolyticus bacteremia postoperatively that was unresponsive to vancomycin alone. The addition of oral rifampin to the vancomycin regimen provided a synergistic effect (serum inhibitory titer and serum bactericidal titer both ⩾ 1:64). The 5. haemolyticus was eradicated as judged by negative blood cultures for coagulase-negative Staphylococcus and clinical recovery. Conclusions: In the treatment of an S. haemolyticus bacteremia, the addition of rifampin to vancomycin therapy was effective in eliminating the organism.