Bacteremia due to Methicillin-Resistant Staphylococcus aureus

Holubar, Marisa; Meng, Long; Alegria, William; Deresinski, Stan

doi:10.1016/j.idc.2020.04.003

Cited by 19 publications

(17 citation statements)

References 44 publications

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“…Holubar suggested that the combination of vancomycin or daptomycin with β-lactam antibiotics was associated with a shorter duration of bacteremia, but there was no significant clinical benefit. ( Holubar et al, 2020 ) However, Wang pointed out that the combination therapy has certain clinical benefits, but it may be related to the use of a certain type of beta-lactam drugs in the experimental group, such as ceftaroline, and perhaps ceftaroline itself has anti-MRSA effects. ( Wang et al, 2020 ) Some scholars believe that the clinical effect of combined therapy is related to the length of treatment time and the concentration of IL-10 in the blood.…”

Section: Discussionmentioning

confidence: 99%

Vancomycin, Daptomycin, Antistaphylococcal β-Lactam, and Trimethoprim-Sulfamethoxazole Monotherapy and Combination Therapy in the Management of Methicillin-Resistant Staphylococcus aureus: A Network Meta-Analysis

Lü

Song

et al. 2022

Front. Pharmacol.

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Objective: The aim was to evaluate the efficacy and safety of vancomycin or daptomycin (VAN/DAP), antistaphylococcal β-lactam (ASBL), trimethoprim-sulfamethoxazole (TMP-SMX), and combination therapy of VAN/DAP + ASBL in the management of methicillin-resistant Staphylococcus aureus (MRSA).Methods: Databases including PubMed, Cochrane Library, Embase database, and google scholar were searched on 1 September 2021. The randomized control trials (RCTs) and comparable clinical studies of VAN/DAP, VAN/DAP + ASBL, ASBL, and TMP-SMX in the management of MRSA were identified. A network meta-analysis was conducted with STATA 14.0.Results: Seven RCTs and two matched cohorts with 1,048 patients were included in the analysis. The pooled results showed that VAN/DAP + ASBL had a significantly lower rate of persistent bacteremia >3 days than VAN/DAP alone [OR:0.46, 95%CI (0.26, 0.81), p < 0.001]. No obvious differences were observed in the outcomes of all-cause mortality, relapsed bacteremia, microbiological treatment failure, embolic or metastatic infection, and total adverse events. However, the ranking results showed that VAN/DAP + ASBL had slightly better efficacy (all-cause mortality, persistent bacteremia >3 days, duration of bacteremia, microbiological treatment failure, and relapsed bacteremia) but slightly higher adverse events than VAN/DAP alone. No obvious differences in the comparisons of VAN/DAP vs. ASBL, and VAN/DAP vs TMP-SMX in the analyzed outcomes. The ranking results revealed that ASBL and TMP-SMX did not have better efficacy or lower adverse events compared with the treatment of VAN/DAP.Conclusion: The efficacy of VAN/DAP + ASBL was slightly but not significantly better than VAN/DAP alone in the management of MRSA.

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Section: Discussionmentioning

confidence: 99%

Vancomycin, Daptomycin, Antistaphylococcal β-Lactam, and Trimethoprim-Sulfamethoxazole Monotherapy and Combination Therapy in the Management of Methicillin-Resistant Staphylococcus aureus: A Network Meta-Analysis

Lü

Song

et al. 2022

Front. Pharmacol.

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“…41,760−763 The circumstances of frequent first-line agent failure, and a breadth of agent options for combination, is the basis for two current debates: whether it is sensible to wait until clinical failure of the first-line agents to progress to combination therapy, 764 and then following the decision in favor of combination therapy, the appropriate agent for the combination. 765 While the potential therapeutic benefit of β-lactam combination therapy in Gram-negative infection is beyond doubt (decades of favorable outcome with β-lactam−βlactamase inhibitor combinations, now even further expanded by the newest β-lactamase inhibitor structures), 766 the challenge of developing a rational experimental path toward the identification of favorable combinations with respect to efficacy and safety, is daunting. The selection of the cefazolin-ertapenem pairing for persistent MSSA bacteremia was made on the basis of complementary PBP targeting: cefazolin for PBP1 and ertapenem for PBP2, and was supported by in vitro synergy.…”

Section: β-Lactams Against Bacterial Fortressesmentioning

confidence: 99%

“…Current practice in the case of clinical failure of these agents is the addition of another antibacterial (combination therapy) . Depending on the infection circumstance the added antibacterial is selected from among clinically established non-β-lactam Gram-positive antibacterials (such as linezolid, trimethoprim-sulfamethazole, and fosfomycin), clinically established β-lactams (such as imipenem and ertapenem), the newest-generation cephalosporins ceftobiprole (approved in Europe) and ceftaroline fosamil (approved in the US), − and from among six other newly approved agents (oritavancin, dalbavancin, telavancin, tedizolid, delafloxacin, and omadacycline). ,− The circumstances of frequent first-line agent failure, and a breadth of agent options for combination, is the basis for two current debates: whether it is sensible to wait until clinical failure of the first-line agents to progress to combination therapy, and then following the decision in favor of combination therapy, the appropriate agent for the combination . While the potential therapeutic benefit of β-lactam combination therapy in Gram-negative infection is beyond doubt (decades of favorable outcome with β-lactam−β-lactamase inhibitor combinations, now even further expanded by the newest β-lactamase inhibitor structures), the challenge of developing a rational experimental path toward the identification of favorable combinations with respect to efficacy and safety, is daunting.…”

Section: Against the Fortressmentioning

confidence: 99%

β-Lactams against the Fortress of the Gram-Positive Staphylococcus aureus Bacterium

Fisher

Mobashery

2020

Chem. Rev.

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The biological diversity of the unicellular bacteriawhether assessed by shape, food, metabolism, or ecological nichesurely rivals (if not exceeds) that of the multicellular eukaryotes. The relationship between bacteria whose ecological niche is the eukaryote, and the eukaryote, is often symbiosis or stasis. Some bacteria, however, seek advantage in this relationship. One of the most successfulto the disadvantage of the eukaryoteis the small (less than 1 μm diameter) and nearly spherical Staphylococcus aureus bacterium. For decades, successful clinical control of its infection has been accomplished using β-lactam antibiotics such as the penicillins and the cephalosporins. Over these same decades S. aureus has perfected resistance mechanisms against these antibiotics, which are then countered by new generations of β-lactam structure. This review addresses the current breadth of biochemical and microbiological efforts to preserve the future of the β-lactam antibiotics through a better understanding of how S. aureus protects the enzyme targets of the β-lactams, the penicillin-binding proteins. The penicillin-binding proteins are essential enzyme catalysts for the biosynthesis of the cell wall, and understanding how this cell wall is integrated into the protective cell envelope of the bacterium may identify new antibacterials and new adjuvants that preserve the efficacy of the β-lactams.

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“…Distinguishing methicillin-susceptible S. aureus (MSSA) from methicillin-resistant S. aureus (MRSA) is fundamental for therapeutic choices, since, among β-lactam antibiotics, only fifth-generation cephalosporins currently remain active against MRSA (whereas some other anti-staphylococcal β-lactams can be used for treating MSSA infections). 6 , 7 This crucial difference has important clinical implications. Indeed, it implies different treatment algorithms (in terms of potential antibiotic choices besides source control whenever necessary) for MSSA and MRSA infections.…”

Section: Introductionmentioning

confidence: 99%

Emerging Treatment Options for Acute Bacterial Skin and Skin Structure Infections and Bloodstream Infections Caused by Staphylococcus aureus: A Comprehensive Review of the Evidence

Giacobbe¹,

Dettori²,

Corcione³

et al. 2022

IDR

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Staphylococcus aureus remains an important human pathogen of concern, with mortality rates surpassing 30% in the case of severe systemic infections. Distinguishing methicillin-susceptible S. aureus from methicillin-resistant S. aureus (MRSA) is fundamental for therapeutic choices. A crucial emerging concept in the treatment of acute bacterial skin and skin structure infections is the availability of various approved agents with anti-MRSA activity, which allow a personalized approach based on the characteristics of any given patient while at the same time remaining in line with high certainty efficacy evidence from large randomized controlled trials. Regarding the treatment of S. aureus bloodstream infections (BSI), interesting aspects that may become relevant in the near future are the presence of both old and novel agents in phase-2 or phase-3 of clinical development for this indication, and the pressing need for high certainty evidence to guide the possible use of combination therapy in specific categories or phenotypes of patients with complicated MRSA BSI.

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Bacteremia due to Methicillin-Resistant Staphylococcus aureus

Cited by 19 publications

References 44 publications

Vancomycin, Daptomycin, Antistaphylococcal β-Lactam, and Trimethoprim-Sulfamethoxazole Monotherapy and Combination Therapy in the Management of Methicillin-Resistant Staphylococcus aureus: A Network Meta-Analysis

Vancomycin, Daptomycin, Antistaphylococcal β-Lactam, and Trimethoprim-Sulfamethoxazole Monotherapy and Combination Therapy in the Management of Methicillin-Resistant Staphylococcus aureus: A Network Meta-Analysis

β-Lactams against the Fortress of the Gram-Positive Staphylococcus aureus Bacterium

Emerging Treatment Options for Acute Bacterial Skin and Skin Structure Infections and Bloodstream Infections Caused by Staphylococcus aureus: A Comprehensive Review of the Evidence

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