Saravu Kavitha, Mukhopadhyay Chiranjay, Satyanarayanan Vishwanath, Pai Ananth, Komaranchath Ashok Sebastian, Munim Frenil, Shastry Barkur Ananthakrishna, Tom Devasia
Department of Internal Medicine, Kasturba Medical College, Manipal University, Karnataka, India.
Scand J Infect Dis. 2012 Jul;44(7):544-7. doi: 10.3109/00365548.2012.657233. Epub 2012 Mar 4.
Vancomycin is the drug of choice in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection. However, the presence of certain clinical complications like renal failure alters vancomycin pharmacokinetics, leading to drug accumulation and toxicity. This highlights the need to identify an effective substitute for treating MRSA infections when vancomycin cannot be used. We report the case of a 57-y-old Indian male diagnosed with tricuspid valve endocarditis with septicaemia and a right upper lobe cavity caused by MRSA. The patient also presented with renal failure, which precluded the use of vancomycin for treatment. A 6-week regimen of teicoplanin and rifampicin was used instead, and the infection was successfully treated. This case report provides evidence of the effectiveness of teicoplanin and rifampicin in the treatment of MRSA bacteraemia in situations where the use of vancomycin is contraindicated.
万古霉素是治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的首选药物。然而,某些临床并发症如肾衰竭的存在会改变万古霉素的药代动力学,导致药物蓄积和毒性。这凸显了在无法使用万古霉素时,需要找到一种有效的替代药物来治疗MRSA感染。我们报告了一例57岁的印度男性病例,该患者被诊断为三尖瓣心内膜炎合并败血症以及由MRSA引起的右上叶空洞。患者还伴有肾衰竭,这使得无法使用万古霉素进行治疗。取而代之的是使用了为期6周的替考拉宁和利福平治疗方案,感染得到了成功治愈。本病例报告提供了证据,证明在禁忌使用万古霉素的情况下,替考拉宁和利福平治疗MRSA菌血症是有效的。