Successful Treatment of Persistent MRSA Bacteremia using High-dose Daptomycin Combined with Rifampicin

Hideharu Hagiya; Tomohiro Terasaka; Kosuke Kimura; Asuka Satou; Kikuko Asano; Koichi Waseda; Yoshihisa Hanayama; Fumio Otsuka

doi:10.2169/internalmedicine.53.2711

CASE REPORTS

Successful Treatment of Persistent MRSA Bacteremia using High-dose Daptomycin Combined with Rifampicin

Hideharu Hagiya, Tomohiro Terasaka, Kosuke Kimura, Asuka Satou, Kikuko Asano, Koichi Waseda, Yoshihisa Hanayama, Fumio Otsuka

Author information

Hideharu Hagiya
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Tomohiro Terasaka
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Kosuke Kimura
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Asuka Satou
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Kikuko Asano
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Koichi Waseda
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Yoshihisa Hanayama
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Fumio Otsuka
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan

Keywords: daptomycin (DAP), methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus bacteremia (SAB), butyrylcholinesterase (BChE) deficiency

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 18 Pages 2159-2163

DOI https://doi.org/10.2169/internalmedicine.53.2711

Details

Abstract

We herein report a case of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that was successfully treated with combination therapy consisting of high-dose daptomycin (DAP, 10 mg/kg) and rifampicin. The patient's condition was complicated with multiple infectious foci, including an iliopsoas abscess and epidural abscess, as well as discitis and spondylitis at the cervical, thoracic and lumbar levels. Monotherapy treatments with vancomycin, linezolid and usual-dose DAP were all ineffective. It has been shown that usual-dose DAP administration may result in the emergence of a resistant strain and treatment failure. We would like to emphasize the importance of high-dose DAP therapy for MRSA bacteremia, a condition with a potentially high mortality rate.

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