Document Detail

Daptomycin cure after cefazolin treatment failure of Methicillin-sensitive Staphylococcus aureus (MSSA) tricuspid valve acute bacterial endocarditis from a peripherally inserted central catheter (PICC) line.
MedLine Citation:
PMID:  16324966     Owner:  NLM     Status:  MEDLINE    
Right-sided acute bacterial endocarditis (ABE) is an infrequent complication of central intravenous (IV) lines. We report a case of methicillin-sensitive Staphylococcus aureus tricuspid valve (TV) ABE related to a peripherally inserted central catheter line (PICC). Patients with right-sided ABE present with symptoms of fever and chills, and symptoms and signs of pulmonary emboli. In the patient presented, the PICC line was removed and high-dose cefazolin therapy, 2 g (IV) every 8 hours, was initiated. Although the patient's blood cultures became negative during the third week of cefazolin therapy, her erythrocyte sedimentation rate and teichoic acid antibody titers remained high. Pulmonary emboli developed. A large TV vegetation (1 x 2 cm) remained unchanged after 4 weeks of cefazolin therapy. For these reasons, cefazolin treatment was considered a treatment failure. Therapy with daptomycin was initiated at a dose of 6 mg/kg (IV) every 24 hours. During daptomycin therapy, the patient's erythrocyte sedimentation rate and teichoic acid antibody titers gradually returned to normal. Repeat transthoracic echocardiograph revealed the TV vegetation was gone and the methicillin-sensitive Staphylococcus aureus ABE was cured with daptomycin. We conclude daptomycin is a rapidly bactericidal antistaphylococcal antibiotic reliably effective even when other usually effective antistaphylococcal antibiotics have failed.
Burke A Cunha; Naveed Hamid; Heather Kessler; Subha Parchuri
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart & lung : the journal of critical care     Volume:  34     ISSN:  0147-9563     ISO Abbreviation:  Heart Lung     Publication Date:    2005 Nov-Dec
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0330057     Medline TA:  Heart Lung     Country:  United States    
Other Details:
Languages:  eng     Pagination:  442-7     Citation Subset:  AIM; IM    
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA.
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MeSH Terms
Acute Disease
Anti-Bacterial Agents / therapeutic use
Catheterization, Central Venous / adverse effects*
Cefazolin / therapeutic use*
Daptomycin / therapeutic use*
Endocarditis, Bacterial / drug therapy*,  etiology,  microbiology
Follow-Up Studies
Methicillin Resistance
Pregnancy Complications, Infectious / drug therapy*,  etiology,  microbiology
Pregnancy Trimester, Third
Staphylococcal Infections / drug therapy*,  etiology,  microbiology
Staphylococcus aureus / drug effects*,  isolation & purification
Tricuspid Valve
Reg. No./Substance:
0/Anti-Bacterial Agents; 103060-53-3/Daptomycin; 25953-19-9/Cefazolin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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