High-Dose Daptomycin plus Fosfomycin Is Safe and Effective in Treating Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Endocarditis

• DOI: 10.1128/aac.06449-11
• Publication Date: 2012-05-30T03:24:37Z
• Authors: José M. Miró; José M. Entenza; Ana del Río; Maria Velasco; Ximena Castañeda; Cristina Garcia d...; Marlyse Giddey; Yolanda Armero; Juan M. Pericàs; Carlos Cervera; Carlos A. Mestres; Manuel Almela; Carlos Falces; Francesc Marco; Philippe Moreillon; Asuncion Moreno
• Keywords: Male; Methicillin-Resistant Staphylococcus aureus; 0301 basic medicine; Drug Synergism; Endocarditis, Bacterial; Microbial Sensitivity Tests; Middle Aged; Staphylococcal Infections; Anti-Bacterial Agents; 3. Good health; 03 medical and health sciences; Daptomycin; Fosfomycin; Humans; Drug Therapy, Combination; Female; Aged

ABSTRACT

We describe 3 patients with left-sided staphylococcal endocarditis (1 with methicillin-susceptible Staphylococcus aureus [MSSA] prosthetic aortic valve endocarditis and 2 with methicillin-resistant S. aureus [MRSA] native-valve endocarditis) who were successfully treated with high-dose intravenous daptomycin (10 mg/kg/day) plus fosfomycin (2 g every 6 h) for 6 weeks. This combination was tested in vitro against 7 MSSA, 5 MRSA, and 2 intermediately glycopeptide-resistant S. aureus isolates and proved to be synergistic against 11 (79%) strains and bactericidal against 8 (57%) strains. This combination deserves further clinical study.