Adding a Beta-Lactam to Vancomycin in MRSA Bacteremia

Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with considerable mortality. Even though other antibiotics with anti-MRSA activity have become available (e.g., linezolid, daptomycin, ceftauroline), vancomycin has remained the standard of care. Based on preclinical evidence showing a potential benefit, the combination of beta-lactams with vancomycin has been investigated in clinical trials, most recently in CAMERA2. However, no survival benefit has been demonstrated so far. In fact, such combinations appear to increase the risk for acute kidney injury (AKI).

Researchers further dig into this adverse effect in a post hoc analysis of 350 patients in CAMERA2, based on their beta-lactam exposure — “none,” “early…