MRSA is known to cause deep seated infections as a complication of bacteremia. Standard treatment includes Vancomycin, Linezolid or Daptomycin. Side effects, increasing Vancomycin minimum inhibitory concentration (MIC), treatment failures and cost are frequently encountered. As a result, alternative agents such as CF have been utilized despite its off label indication.
Retrospective chart review of adult patients who received CF for MRSA bacteremia and deep seated infections between August 2011 and March 2015 in three central Texas Hospitals. We measured the duration of CF, recurrence of bacteremia, adverse events and clinical cure as defined by resolution of signs and symptoms at end of therapy.
We included 28 patients with MRSA bacteremia and deep seated infection, 12 of which had a definitive diagnosis of infective endocarditis (IE). Twenty-seven of these patients received standard therapy for a mean of 7 days (range 1-42 days) prior to starting CF. Twenty of the patients had a Vancomycin MIC of ≥2µg/mL. Four patients with IE received combination therapy as a salvage treatment. The mean duration of therapy with CF was 32 days (range 7-56 days). Twenty-seven patients had clinical cure and no evidence of recurrent bacteremia after starting CF. Only one patient stopped CF due to acute renal failure.
CF can be considered an effective agent for the continuation of treatment for MRSA bacteremia, endocarditis and other deep seated infections.
J. Koshy, None
K. Brust, None
J. Midturi, None
L. Cahuayme-Zuniga, None
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