Should daptomycin-rifampin combinations for MSSA/MRSA isolates be avoided because of antagonism?

Infection
C SteinM W Pletz

Abstract

There is increasing clinical evidence from observational studies, that combination therapy of daptomycin with rifampin is a valuable treatment option for biofilm-associated difficult to treat Staphylococcus aureus infections such as osteomyelitis, prosthetic joint infection and endocarditis. However, two studies analyzing a limited number of S. aureus isolates reported an antagonism of those two drugs questioning the benefit of this combination. To estimate the frequency of this possible antagonism, we performed in vitro checkerboard assays on 58 consecutive clinical isolates of S. aureus (MSSA n = 9, MRSA n = 49). We determined the fractional inhibitory concentration index (FICI) and the susceptible breakpoint index (SBPI). All isolates were characterized by a microprobe array detecting 336 different genes/alleles to ensure their non-clonal origin. For all isolates, the FICI was between 1.00 and 1.25 indicating additive effects for the daptomycin/rifampin combination. Neither antagonism nor synergism as defined by the FICI was found for any of the isolates. Based on these data, there is no evidence to advise against the daptomycin/rifampin combination therapy.

References

May 29, 2002·Proceedings of the National Academy of Sciences of the United States of America·Mark C EnrightBrian G Spratt
Jan 24, 2008·The Annals of Pharmacotherapy·Graeme N ForrestLawrence V Friedrich
May 13, 2009·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·S MoneckeR Ehricht
Jul 22, 2009·Antimicrobial Agents and Chemotherapy·J M MiróUNKNOWN Hospital Clinic Experimental Endocarditis Study Group
Jan 7, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Catherine LiuUNKNOWN Infectious Diseases Society of America
Aug 23, 2011·Diagnostic Microbiology and Infectious Disease·Theodoros KelesidisOtto O Yang
Aug 10, 2013·The Journal of Antimicrobial Chemotherapy·Ravina KullarMichael J Rybak

❮ Previous
Next ❯

Citations

Apr 6, 2017·Medizinische Klinik, Intensivmedizin und Notfallmedizin·S WeisM W Pletz
Nov 19, 2019·Frontiers in Pharmacology·Ruo-Yue HuangHualin Fu
Oct 19, 2019·The Journal of Antibiotics·Maria V GolikovaAlexander A Firsov

❮ Previous
Next ❯

Related Concepts

Related Feeds

Biofilm & Infectious Disease

Biofilm formation is a key virulence factor for a wide range of microorganisms that cause chronic infections.Here is the latest research on biofilm and infectious diseases.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

CRISPR & Staphylococcus

CRISPR-Cas system enables the editing of genes to create or correct mutations. Staphylococci are associated with life-threatening infections in hospitals, as well as the community. Here is the latest research on how CRISPR-Cas system can be used for treatment of Staphylococcal infections.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.