达托霉素联合头孢洛林治疗高水平庆大霉素耐药粪肠球菌心内膜炎。
Treatment of high-level gentamicin-resistant Enterococcus faecalis endocarditis with daptomycin plus ceftaroline.
机构信息
Department of Pediatric Pharmacology and Drug Discovery, University of California San Diego School of Medicine, La Jolla, California, USA.
出版信息
Antimicrob Agents Chemother. 2013 Aug;57(8):4042-5. doi: 10.1128/AAC.02481-12. Epub 2013 May 20.
Abstract
A recurrent case of left-sided endocarditis caused by high-level aminoglycoside-resistant Enterococcus faecalis was successfully treated with ceftaroline and daptomycin. This combination demonstrated excellent synergy in vitro. Mechanistically, ceftaroline enhanced binding of daptomycin to the cell membrane and sensitized E. faecalis to killing by human cathelicidin LL-37, a cationic innate host defense peptide. Daptomycin plus ceftaroline may be considered in salvage therapy in E. faecalis endovascular infections and requires further study.
摘要
高水平氨基糖苷类耐药粪肠球菌引起的复发性左侧心内膜炎经头孢洛林和达托霉素成功治疗。该联合方案在体外显示出极好的协同作用。从机制上讲，头孢洛林增强了达托霉素与细胞膜的结合，并使粪肠球菌对人杀菌肽 LL-37 的杀伤作用敏感，LL-37 是一种阳离子先天宿主防御肽。达托霉素加头孢洛林可考虑用于粪肠球菌血管内感染的挽救治疗，尚需进一步研究。
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