Management of MRSA/GISA, VISA Endocarditis

Infective endocarditis is a worrisome disease, with no significant decrease of the incidence and mortality in the last decade. Despite a changing epidemiology over the last few years, S. aureus remains the leading causative organism in Canada, the U.S., and Europe. Experimental animal models of endocarditis have been extensively used to evaluate the activity of new drugs or new regimens. Although vancomycin has shown satisfactory in vivo activity against MRSA, the drug has failed to demonstrate a bactericidal activity against isolates with reduced susceptibility to glycopeptides. Among the new, recently available antimicrobial agents, experimental data strongly support daptomycin and ceftaroline fosamil as effective options. In clinical practice, vancomycin continues to be recommended for the treatment of IE caused by MRSA. However, its use is more and more debated, especially with the availability of new effective therapeutic options. Further studies are needed to define the role of these new antimicrobials in the treatment of MRSA and GISA endocarditis.