For MRSA Bacteremia, Two Antibiotics Weren't Better Than One

In a randomized trial, adding a β-lactam to vancomycin or daptomycin for methicillin-resistant S. aureus bacteremia yielded no clinical benefit.

Animal models and retrospective studies in humans with methicillin-resistant S. aureus (MRSA) bacteremia suggest that adding a β-lactam to daptomycin or vancomycin improves outcomes, possibly due to the combination's in vitro synergy for killing MRSA. In a randomized, open-label clinical trial, investigators tested the effectiveness of adding 7 days of cefazolin, flucloxacillin, or oxacillin to daptomycin or vancomycin for the treatment of hospitalized patients with MRSA bacteremia. The primary endpoint was a composite of 90-day mortality, continuing bacteremia at day 5, microbiologic relapse, or microbiologic failure. At the planned interim analysis, 174 patients had been randomized to combination therapy and 178 to standard therapy.

The pr…

Reviewing Author

Hana M. El Sahly, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Hana M. El Sahly, MD

Disclosures

Grant/Research SupportNational Institutes of Health

For MRSA Bacteremia, Two Antibiotics Weren't Better Than One

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Reviewing Author