Daptomycin plus Cloxacillin or Ceftaroline for Methicillin-Susceptible Staphylococcus aureus Endocarditis

In a rabbit endocarditis model, low-dose daptomycin plus cloxacillin or ceftaroline resulted in valve sterilization in ≥90% of animals without development of daptomycin nonsusceptibility.

Methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) traditionally has been managed with β-lactam antibiotics and is associated with 20% to 25% mortality. An experimental model has revealed synergism between daptomycin and β-lactam antibiotics that could improve outcomes. Now, researchers have used a model of MSSA IE in rabbits to examine monotherapy with cloxacillin, ceftaroline, or daptomycin (6 mg/kg daily [daptomycin-LD] or 10 mg/kg/daily [daptomycin-HD]) compared with combinations of daptomycin-LD plus cloxacillin (2 g every 4 hours) or ceftaroline (600 mg infused every 8 hours).

Any dose of daptomycin, cloxacillin, or ceftaroline alone resulted in sterilized valvular vegetations in ≤53% of animals, compared …

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Daptomycin plus Cloxacillin or Ceftaroline for Methicillin-Susceptible Staphylococcus aureus Endocarditis

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Reviewing Author