Oral antibiotic treatment of right-sided staphylococcal endocarditis in injection drug users: Prospective randomized comparison with parenteral therapy

Heldman, Alan W.; Hartert, Tina; Ray, Stuart C.; Daoud, Emile G.; Kowalski, Thomas E.; Pompili, Vincent J.; Sisson, Stephen D.; Tidmore, William C.; Eigen, Keith A. vom; Goodman, Steven N.; Lietman, Paul S.; Petty, Brent G.; Flexner, Charles

doi:10.1016/s0002-9343(96)00070-8

Cited by 253 publications

(132 citation statements)

References 26 publications

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“…Two studies have evaluated the use of predominantly oral 4-week antibiotic regimens (ciprofloxacin plus rifampin) for the therapy of uncomplicated right-sided S aureus endocarditis in IDUs. 96,97 In each study, including one in which Ͼ70% of patients were HIV-seropositive, 97 cure rates were Ͼ90%.…”

Section: Right-sided Endocarditis In Idusmentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

1,277

436

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Background-Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. Methods and Results-This work represents the third iteration of an infective endocarditis "treatment" document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. Conclusions-The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management. (Circulation. 2005; 111:e394-e433.)

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Section: Right-sided Endocarditis In Idusmentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

1,277

436

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“…Clinical investigations have examined the potential for synergy employing a combination of gentamicin and vancomycin and report mixed results (1,12,16,21,25,28,35,44). In the present investigation, high-dose regimens involving gentamicin combined with vancomycin resulted in enhancement, while high-dose gentamicin regimens combined with daptomycin did not result in enhancement at the 4-day endpoint.…”

Section: Vol 49 2005 Short-course Gentamicin Regimen Against S Aurmentioning

confidence: 49%

Short-Course Gentamicin in Combination with Daptomycin or Vancomycin against Staphylococcus aureus in an In Vitro Pharmacodynamic Model with Simulated Endocardial Vegetations

Tsuji

Rybak

2005

Antimicrob Agents Chemother

109

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The ability to maximize bactericidal activity while minimizing toxicity is a therapeutic goal in the treatment of infective endocarditis. We evaluated the impact of administering short-course regimens of gentamicin in combination with daptomycin or vancomycin against one methicillin-susceptible (MSSA 1199) and one methicillin-resistant (MRSA 494) Staphylococcus aureus isolate using an in vitro pharmacodynamic model with simulated endocardial vegetations over 96 h. Human therapeutic dosing regimens for daptomycin (6 and 8 mg/kg of body weight), vancomycin, and gentamicin were simulated. Short-course combination regimens involving gentamicin were administered either as a single 5-mg/kg dose or three 1-mg/kg doses for only the first 24 h and compared to the regimens administered for the full 96-h duration. For all experiments, physiologic conditions of albumin, calcium, and pH were simulated. Both regimens of daptomycin achieved 99.9% kill by 32 h and maintained bactericidal activity against both isolates, which was significantly different from vancomycin, which displayed bacteriostatic activity (P < 0.05). The effects of all short-course regimens of gentamicin were equal to those of the full-duration regimens in combination with daptomycin. Adding three doses of gentamicin (1 mg/kg) to daptomycin resulted in enhancement and bactericidal activity at 24 h against both MRSA and MSSA. The addition of a single dose of gentamicin (5 mg/kg) enhanced or improved the activity of daptomycin and resulted in early bactericidal activity at 4 h against both isolates. The addition of three doses of gentamicin (1 mg/kg) did not improve the activity of vancomycin. However, the addition of a single 5-mg/kg dose of gentamicin to vancomycin resulted in early enhancement at 4 h and 99.9% kill at 32 h for MRSA. These results suggest that a single high dose of gentamicin in combination with daptomycin or vancomycin may be of utility to maximize synergistic and bactericidal activity and minimize toxicity. Further investigation is warranted.

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“…Of these 44 patients, 95% of the patients had S. aureus bacteremia, with MRSA being the causative organism for only 5 of these patients. There were 4 clinical failures: 1 of the 19 patients (5%) in the combination therapy group and 3 of the 25 (12%) patients in the intravenous therapy group (P Ͼ 0.05) (115). Those authors suggested that for selected patients, the rifampin-ciprofloxacin combination was safe and effective for right-sided endocarditis; however, it should be noted that barely half the patients enrolled completed the study (115).…”

Section: Staphylococcimentioning

confidence: 99%

“…All 10 patients that completed therapy had bacteria cleared from blood cultures at 4 weeks; however, 4 patients did not complete therapy due to nonadherence, a concern for outpatient endocarditis therapy (74). Subsequently, two larger prospective studies evaluated the role of oral quinolone-rifampin therapy in right-sided endocarditis (115,222). Heldman et al performed a prospective, randomized, unblinded trial comparing ciprofloxacin (750 mg b.i.d.)…”

Section: Staphylococcimentioning

confidence: 99%

Rifampin Combination Therapy for Nonmycobacterial Infections

2010

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SUMMARY The increasing emergence of antimicrobial-resistant organisms, especially methicillin-resistant Staphylococcus aureus (MRSA), has resulted in the increased use of rifampin combination therapy. The data supporting rifampin combination therapy in nonmycobacterial infections are limited by a lack of significantly controlled clinical studies. Therefore, its current use is based upon in vitro or in vivo data or retrospective case series, all with major limitations. A prominent observation from this review is that rifampin combination therapy appears to have improved treatment outcomes in cases in which there is a low organism burden, such as biofilm infections, but is less effective when effective surgery to obtain source control is not performed. The clinical data support rifampin combination therapy for the treatment of prosthetic joint infections due to methicillin-sensitive S. aureus (MSSA) after extensive debridement and for the treatment of prosthetic heart valve infections due to coagulase-negative staphylococci. Importantly, rifampin-vancomycin combination therapy has not shown any benefit over vancomycin monotherapy against MRSA infections either clinically or experimentally. Rifampin combination therapy with daptomycin, fusidic acid, and linezolid needs further exploration for these severe MRSA infections. Lastly, an assessment of the risk-benefits is needed before the addition of rifampin to other antimicrobials is considered to avoid drug interactions or other drug toxicities.

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Oral antibiotic treatment of right-sided staphylococcal endocarditis in injection drug users: Prospective randomized comparison with parenteral therapy

Cited by 253 publications

References 26 publications

Infective Endocarditis

Infective Endocarditis

Short-Course Gentamicin in Combination with Daptomycin or Vancomycin against Staphylococcus aureus in an In Vitro Pharmacodynamic Model with Simulated Endocardial Vegetations

Rifampin Combination Therapy for Nonmycobacterial Infections

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