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Topics:
General Internal Medicine • Infectious Disease • Critical Care • General Infectious Disease • General Hospital Medicine
Do you use combination therapy for persistent MSSA bacteremia?
If yes, which combination(s)?
Answer from: at Academic Institution
A wide variety of combinations have been used (Chastain et al., PMID 36946576), but there is no solid convincing evidence favoring any single one. In addition, there is strong evidence indicating a clinical (as opposed to, perhaps, a microbiological benefit). I have, however, used cefazolin together...
Comments
at Community Hospital
What is the rationale for using double beta-lactam...
What is the rationale for using double beta-lactam...
at Stanford
Ulloa et al., PMID 31773134
Ulloa et al., PMID 31773134
at Lexington Medical Specialists
Thanks for sharing the study, I was not familiar w...
Thanks for sharing the study, I was not familiar w...
at Central Georgia Infectious Diseases Llc
Source control and host factors must be determined...
Source control and host factors must be determined...
Answer from: at Community Practice
I've done this in a couple of cases when desperate. Excellent comments and references above, including Dr. @Deresinski's mention of the CID 2020 case series.One more single case report to mention: Sakoulas et al., PMID 27572414Cefazolin/Erta likewise successfully cleared persistent MSSA bacteremia a...
Answer from: at Community Practice
I usually do not have a problem with single therapy. Though if bioburden is high and the patient is critical, I tend to use Nafcillin first, then may consider switching to Cefazolin (more convenient for OPAT) once clinically improved, though source control is still the more important first step.
I agree. Source control is the first priority.