Use of antistaphylococcal beta-lactams to increase daptomycin activity in eradicating persistent bacteremia due to methicillin-resistant Staphylococcus aureus: role of enhanced daptomycin binding

Clin Infect Dis. 2011 Jul 15;53(2):158-63. doi: 10.1093/cid/cir340.

Abstract

We used daptomycin plus antistaphylococcal β-lactams (ASBL) to clear refractory MRSA bacteremia. In vitro studies showed enhanced daptomycin bactericidal activity, increased membrane daptomycin binding, and decrease in positive surface charge induced by ASBLs against daptomycin nonsusceptible MRSA. Addition of ASBLs to daptomycin may be of benefit in refractory MRSA bacteremia. (Although the official designation is "daptomycin nonsusceptiblity," we will use the term "daptomycin-resistance" in this paper for facility of presentation.).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacology
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology*
  • Cell Membrane / chemistry
  • Cell Membrane / physiology
  • Daptomycin / administration & dosage*
  • Daptomycin / pharmacology
  • Drug Resistance, Bacterial*
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Male
  • Membrane Potentials / drug effects
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Treatment Outcome
  • beta-Lactams / administration & dosage*
  • beta-Lactams / pharmacology

Substances

  • Anti-Bacterial Agents
  • beta-Lactams
  • Daptomycin