Use of quinupristin/dalfopristin in a critical patient with a methicillin-resistant Staphilococcus aureus infection

Minerva Anestesiol. 2004 Oct;70(10):747-9; 749-51.
[Article in English, Italian]

Abstract

The growing incidence of infections due to Gram-positive multiresistant germs has stimulated research into new drugs endowed with broader activity, that are useful in case of infections unresponsive to common antibiotics. The case of a 28-year-old man infected with a methicillin resistant Staphylococcus aureus non responder to therapy with glycopeptide antibiotics is reported. At admission the patient presented a septic condition and required mechanical ventilation. Antibiotic therapy was immediately started with teicoplanin+meropenem. Blood culture and bronchial aspirate evidenced a methicillin resistant Staphylococcus aureus with high sensibility to glycopeptide antibiotics. Although this therapy produced a slight improvement in clinical condition and the patient was extubated, fever and leucocytosis associated with a BAL positive to methicillin resistant Staphylococcus aureus, in vitro susceptible to glycopeptides, persisted. Considering the possibility of a non-responder condition of the patient to glycopeptide antibiotics, quinupristin/dalfopristin was added. The streptogramin produced a quick improvement in clinical condition with resolution of sepsis and culture sterilization. The patient improved progressively and was discharged. In conclusion, in our experience the association quinupristin/dalfopristin was effective in the resolution of a critical methicillin resistant Staphylococcus aureus infection non responder to classical treatment with glycopeptide antibiotics that showed a high sensibility in vitro.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Critical Illness*
  • Humans
  • Male
  • Methicillin Resistance
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / microbiology
  • Thoracic Injuries / complications
  • Thoracic Injuries / diagnostic imaging
  • Tomography, X-Ray Computed
  • Virginiamycin / analogs & derivatives*
  • Virginiamycin / therapeutic use*
  • Wounds, Stab / complications
  • Wounds, Stab / diagnostic imaging

Substances

  • Anti-Bacterial Agents
  • Virginiamycin
  • quinupristin