Glycopeptide insensitive Staphylococcus aureus subdural empyema treated with linezolid and rifampicin

Gallagher, R.M.; Pizer, Barry; Ellison, Joann; Riordan, F. A. I.

doi:10.1016/j.jinf.2008.06.023

Cited by 12 publications

(4 citation statements)

References 13 publications

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“…19 In an experimental model of MRSA endocarditis in rabbits, Tsaganos et al 20 demonstrated synergistic activity with the combination of linezolid and rifampin. Published clinical studies reporting coadministration of linezolid with rifampin either in retrospective and observational studies [21][22][23] or in case reports [24][25][26] have not reported lack of efficacy when linezolid and rifampin were used in combination, with the exception of the above-mentioned case reported by Gebhart et al 7 Based on presently available in vitro, in vivo, and clinical data, the clinical significance of the decreased levels of linezolid due to coadministration with rifampin remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Effect of Rifampin on the Pharmacokinetics of Linezolid: In Silico and In Vitro Approaches to Explain Its Mechanism

Gandelman

Zhu

Fahmi

et al. 2011

The Journal of Clinical Pharmacology

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The effect of rifampin on the steady-state pharmacokinetics of linezolid was evaluated in an open-label, multiple-dose, crossover study in 16 healthy subjects. When coadministered with rifampin, area under the plasma concentration-time curve over the dosing interval and maximum concentration values for linezolid were reduced approximately 32% and 21%, respectively. Time to maximum concentration and apparent volume of distribution were generally similar between treatments. The mean half-life and apparent oral clearance were decreased for the combination treatment compared with linezolid alone. In vitro and in silico approaches were used to evaluate this interaction. In human hepatocytes, the metabolism of linezolid was increased by 1.3- to 1.6-fold when the cells were pretreated with rifampin, compared with a 19- to 40-fold increase in testosterone metabolism, a positive control for cytochrome P4503A activity. This increase in linezolid and testosterone metabolism was partially inhibited (~50%) by ketoconazole. Modeling of these data using Simcyp suggested that rifampin inducible drug metabolizing enzymes, such as cytochrome P4503A, have a very minor contribution to linezolid clearance, which increases when rifampin is coadministered. The clinical significance of the decreased linezolid levels is unclear. Linezolid and rifampin administered alone or in combination was generally safe and well tolerated.

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Section: Discussionmentioning

confidence: 99%

Unexpected Effect of Rifampin on the Pharmacokinetics of Linezolid: In Silico and In Vitro Approaches to Explain Its Mechanism

Gandelman

Zhu

Fahmi

et al. 2011

The Journal of Clinical Pharmacology

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“…In our literature research, we found out that rifampin may be beneficial as it achieves bactericidal concentrations in the CSF, regardless of meningeal inflammation, and can be used as a form of treatment. The recommended dose was 600 mg orally or IV once daily or 300 to 450 mg twice daily [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…We implemented our research findings on our patient with positive outcomes and can safely recommend that rifampin can be added to vancomycin for a combined synergistic effect. In our research, we ascertained, that based upon some case reports and case series of patients with MRSA meningitis, alternatives to vancomycin include linezolid (600 mg IV twice daily) [12], TMP-SMX (5 mg/kg of the trimethoprim component IV every 8 to 12 hours) [9] and daptomycin (6 to 10 mg/kg IV once daily) usually combined with rifampin [13]. Further studies are needed to establish the benefit of these agents for the treatment of meningitis.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus Aureus: A Very Rare Cause of Meningitis

Mehmood¹,

Patel²,

Sanekommu³

2020

Cureus

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Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is mostly implicated in soft tissue and skin infections. Cases with meningitis caused by CA-MRSA are rare. High index of suspicion should be kept for physicians as bacterial meningitis is a medical emergency and if untreated, has a high mortality rate. Urgent steps need to be taken to determine the cause and implement therapy. Here, we reported a case of a 58-year-old female with MRSA bacteremia and meningitis as confirmed by positive blood cultures and cerebrospinal fluid analysis; successfully managed with vancomycin and rifampin.

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“…31,42 It has shown good CNS penetration and thus seems a promising candidate for treatment of CNS infections; 32,46 however, at present, only a small amount of anedoctal data pertaining to CNS infections in children have been reported about efficacy and safety in this setting. 14,15,17,22,[33][34][35] In addition, with recent reports of heteroresistance to vancomycin, linezolid may now represent a necessary alternative in treating infections caused by highly resistant gram-positive organism. 12,43 Also, based on the observations in recent studies, 19,48 linezolid appears to be a promising antibiotic with the potential for treating multidrug-resistant staphylococcal biofilm-associated infections.…”

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confidence: 99%

Linezolid treatment of shunt-related cerebrospinal fluid infections in children

Yılmaz

Dalgıç

Müslüman³

et al. 2010

PED

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Object The emergence of multidrug-resistant bacteria as a cause of ventriculoperitoneal (VP) shunt infection is a disconcerting phenomenon that often requires the use of alternative antimicrobial agents due to resistance against commonly used medications. Linezolid, a member of a new class of antimicrobial agents, has good activity against virtually all important gram-positive pathogens, including multidrug-resistant gram-positive pathogens. The object of this article is to report a single-center experience with linezolid treatment in 6 young patients with VP shunt infections caused by drug-resistant strains. Methods The authors reviewed the records of 6 pediatric patients who developed VP shunt infection and in whom initial antimicrobial treatment regimens, including vancomycin, either failed or were associated with vancomycin-resistant enterococcus. All 6 patients were treated at their hospital between July 1, 2008, and June 29, 2009. The patients' demographic and clinical characteristics, underlying diseases, clinical manifestations, laboratory results, and various treatment modalities used before linezolid therapy were evaluated. Results The 6 patients included were 2 boys and 4 girls with a mean (± SD) age of 11.83 ± 12 months (range 4–36 months). Five patients had acquired an infection within 4 months (mean 7.50 ± 13.51 months, range 1–35 months) after shunt insertion. Four patients were treated with external ventricular drainage. Two patients' parents refused to allow shunt removal and placement of an external ventricular drain. The CSF was clear of bacterial growth within a mean of 3.67 ± 1.36 days (range 2–6 days) after initiation of linezolid treatment. The mean duration of linezolid treatment was 18.17 ± 3.31 days (range 14–21 days). Microbiological clearance of CSF and clinical cure were achieved in all patients. No laboratory or clinical side effects were observed during the treatment period. The mean length of hospital stay was 22.8 ± 4.96 days (range 17–28 days). Conclusions Linezolid could be an appropriate treatment alternative in children with ventriculostomy-related CSF infections caused by drug-resistant strains, including cases in which shunt removal is not an option. Well-designed prospective studies providing additional information on linezolid levels in plasma and CSF are necessary to confirm the authors' observations.

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Glycopeptide insensitive Staphylococcus aureus subdural empyema treated with linezolid and rifampicin

Cited by 12 publications

References 13 publications

Unexpected Effect of Rifampin on the Pharmacokinetics of Linezolid: In Silico and In Vitro Approaches to Explain Its Mechanism

Unexpected Effect of Rifampin on the Pharmacokinetics of Linezolid: In Silico and In Vitro Approaches to Explain Its Mechanism

Methicillin-Resistant Staphylococcus Aureus: A Very Rare Cause of Meningitis

Linezolid treatment of shunt-related cerebrospinal fluid infections in children

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