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Chloramphenicol treatment for vancomycin-resistant Enterococcus faecium bacteremia
J C Ricaurte1, H W Boucher, G S Turett
1Section of Infectious Diseases, Department of Medicine, Saint Vincent's Hospital and Medical Center of New York 10011, USA.
Summary
Chloramphenicol effectively treated vancomycin-resistant Enterococcus faecium (VREF) bacteremia in severely ill cancer patients. This offers a valuable therapeutic option for infections caused by this highly resistant organism.
Area of Science:
- Infectious Diseases
- Internal Medicine
- Clinical Microbiology
Background:
- Vancomycin-resistant Enterococcus faecium (VREF) poses a significant challenge due to limited treatment options.
- Bacteremia caused by VREF requires effective therapeutic strategies, especially in immunocompromised patients.
Purpose of the Study:
- To evaluate the efficacy of chloramphenicol in treating VREF bacteremia.
- To assess clinical and microbiological outcomes in patients receiving chloramphenicol for VREF infections.
Main Methods:
- Retrospective chart review of adult patients treated with chloramphenicol for VREF bacteremia.
- Inclusion criteria: VREF bacteremia, treatment with chloramphenicol for at least 48 hours.
- Analysis of clinical outcomes, microbiological response, and patient demographics.
Main Results:
- Seven episodes of VREF bacteremia in six cancer patients were treated with chloramphenicol.
- All VREF isolates were susceptible to chloramphenicol in vitro.
- Favorable microbiological response in all evaluable episodes (6/6); favorable clinical outcomes in 57% (4/7).
Conclusions:
- Chloramphenicol demonstrated effectiveness in treating VREF bacteremia in a cohort of severely ill cancer patients.
- Consideration of chloramphenicol is warranted for VREF infections due to limited therapeutic alternatives.
- Low attributable mortality (14%) suggests chloramphenicol's potential role in managing VREF infections.