Publication:
Successful management of methicillin-resistant Staphylococcus aureus bacteremia unresponsive to vancomycin by adding fosfomycin: A case report

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Issued Date

2012

Resource Type

Article

File Type

application/pdf

ISSN

1252208

Other identifier(s)

2-s2.0-84864425212

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol 95, No.7 (2012), p.960-963

Suggested Citation

Linasmita P. Successful management of methicillin-resistant Staphylococcus aureus bacteremia unresponsive to vancomycin by adding fosfomycin: A case report. Journal of the Medical Association of Thailand. Vol 95, No.7 (2012), p.960-963. Retrieved from: https://hdl.handle.net/20.500.14740/7014

Title

Successful management of methicillin-resistant Staphylococcus aureus bacteremia unresponsive to vancomycin by adding fosfomycin: A case report

Author(s)

Linasmita P.

Abstract

Background: Vancomycin is the drug of choice for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. However, vancomycin treatment failures are occasionally observed with some strains that are considered susceptible to vancomycin according to Clinical and Laboratory Standards Institute breakpoints (vancomycin minimum inhibitory concentration [MIC] ≤ 2 μg/mL). Although fosfomycin has in vitro activity against MRSA, clinical data regarding the use of fosfomycin either alone or in combination for the management of MRSA bacteremia is limited. Case Report: A 57-year-old woman who was on regular hemodialysis for chronic kidney disease presented with sepsis associated with possible infection of arteriovenous fistula. Blood culture grew MRSA with vancomycin MIC of 1.5 μg/mL. Despite placement of a double-lumen catheter for hemodialysis and treatment with vancomycin and serum concentrations monitoring to keep trough levels of 15 to 20 μg/mL, her blood cultures still continued to grow MRSA for over 10 days. Later, intravenous fosfomycin was added to the regimen along with vancomycin. After three days of this combination, suppression of bacteremia was achieved. Conclusion: Combination of fosfomycin and vancomycin might be another option for the treatment of bacteremia due to MRSA with vancomycin MIC of 1.5 μg/mL that is not responsive to vancomycin alone.

Subject(s)

Fosfomycin
 Fusidic acid
 Rifampicin
 Vancomycin
 Adult
 Aortitis
 Arteriovenous fistula
 Article
 Case report
 Disk diffusion
 Drug dose reduction
 Epsilometer test
 Erythema
 Female
 Fever
 Hemodialysis
 Human
 Methicillin resistant Staphylococcus aureus infection
 Minimum inhibitory concentration
 Mycotic aneurysm
 Recommended drug dose
 Anti-Bacterial Agents
 Drug Therapy, Combination
 Female
 Fosfomycin
 Humans
 Methicillin-Resistant Staphylococcus aureus
 Middle Aged
 Sepsis
 Vancomycin

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URI

https://hdl.handle.net/20.500.14740/7014

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Scopus: Year 1983-2021

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