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高剂量达托霉素联合磷霉素治疗耐甲氧西林敏感和耐甲氧西林金黄色葡萄球菌心内膜炎安全有效。

High-dose daptomycin plus fosfomycin is safe and effective in treating methicillin-susceptible and methicillin-resistant Staphylococcus aureus endocarditis.

机构信息

Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.

出版信息

Antimicrob Agents Chemother. 2012 Aug;56(8):4511-5. doi: 10.1128/AAC.06449-11. Epub 2012 May 29.

DOI:10.1128/AAC.06449-11
PMID:22644033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3421550/
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.

摘要

我们描述了 3 例左侧葡萄球菌性心内膜炎患者(1 例为耐甲氧西林金黄色葡萄球菌 [MSSA] 人工主动脉瓣心内膜炎,2 例为耐甲氧西林金黄色葡萄球菌 [MRSA] 原生瓣膜心内膜炎),他们均成功接受了 6 周高剂量静脉滴注达托霉素(10mg/kg/天)加磷霉素(每 6 小时 2g)治疗。该联合用药在体外对 7 株 MSSA、5 株 MRSA 和 2 株中度糖肽耐药金黄色葡萄球菌分离株进行了测试,结果显示对 11 株(79%)菌株具有协同作用,对 8 株(57%)菌株具有杀菌作用。这种联合用药值得进一步的临床研究。

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High-dose daptomycin plus fosfomycin is safe and effective in treating methicillin-susceptible and methicillin-resistant Staphylococcus aureus endocarditis.高剂量达托霉素联合磷霉素治疗耐甲氧西林敏感和耐甲氧西林金黄色葡萄球菌心内膜炎安全有效。
Antimicrob Agents Chemother. 2012 Aug;56(8):4511-5. doi: 10.1128/AAC.06449-11. Epub 2012 May 29.
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本文引用的文献

1
Use of antistaphylococcal beta-lactams to increase daptomycin activity in eradicating persistent bacteremia due to methicillin-resistant Staphylococcus aureus: role of enhanced daptomycin binding.利用抗葡萄球菌β-内酰胺类药物提高达托霉素对耐甲氧西林金黄色葡萄球菌持续性菌血症的清除作用:增强达托霉素结合的作用。
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High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: case report.高剂量达托霉素和磷霉素治疗达托霉素不敏感金黄色葡萄球菌引起的心内膜炎患者:病例报告。
BMC Infect Dis. 2011 May 26;11:152. doi: 10.1186/1471-2334-11-152.
3
Induction kinetics of the Staphylococcus aureus cell wall stress stimulon in response to different cell wall active antibiotics.金黄色葡萄球菌细胞壁应激应答基因簇在不同细胞壁活性抗生素作用下的诱导动力学研究
BMC Microbiol. 2011 Jan 20;11:16. doi: 10.1186/1471-2180-11-16.
4
Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children.美国传染病学会发布的耐甲氧西林金黄色葡萄球菌感染成人和儿童治疗临床实践指南。
Clin Infect Dis. 2011 Feb 1;52(3):e18-55. doi: 10.1093/cid/ciq146. Epub 2011 Jan 4.
5
Fosfomycin: an old, new friend?磷霉素:故友还是新朋?
Eur J Clin Microbiol Infect Dis. 2010 Feb;29(2):127-42. doi: 10.1007/s10096-009-0833-2. Epub 2009 Nov 14.
6
Clinical significance of the pharmacokinetic and pharmacodynamic characteristics of fosfomycin for the treatment of patients with systemic infections.磷霉素治疗全身感染患者的药代动力学和药效学特征的临床意义。
Int J Antimicrob Agents. 2009 Dec;34(6):506-15. doi: 10.1016/j.ijantimicag.2009.08.013. Epub 2009 Oct 13.
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Addition of gentamicin or rifampin does not enhance the effectiveness of daptomycin in treatment of experimental endocarditis due to methicillin-resistant Staphylococcus aureus.添加庆大霉素或利福平并不能增强达托霉素治疗耐甲氧西林金黄色葡萄球菌所致实验性心内膜炎的有效性。
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Fosfomycin for the treatment of infections caused by Gram-positive cocci with advanced antimicrobial drug resistance: a review of microbiological, animal and clinical studies.磷霉素治疗具有先进抗微生物药物耐药性的革兰阳性球菌引起的感染:微生物学、动物和临床研究综述。
Expert Opin Investig Drugs. 2009 Jul;18(7):921-44. doi: 10.1517/13543780902967624.
9
Transcriptional profiling reveals that daptomycin induces the Staphylococcus aureus cell wall stress stimulon and genes responsive to membrane depolarization.转录谱分析表明,达托霉素可诱导金黄色葡萄球菌细胞壁应激刺激因子及对膜去极化有反应的基因。
Antimicrob Agents Chemother. 2008 Mar;52(3):980-90. doi: 10.1128/AAC.01121-07. Epub 2007 Dec 17.
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Am J Med. 2007 Oct;120(10 Suppl 1):S28-33. doi: 10.1016/j.amjmed.2007.07.011.