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Unsuccessful treatment of methicillin-resistant Staphylococcus aureus endocarditis with dalbavancin

J M Steele1,2, R W Seabury1, C M Hale3

  • 1Department of Pharmacy, State University of New York Upstate Medical University - University Hospital, Syracuse, NY, USA.

Journal of Clinical Pharmacy and Therapeutics
|June 20, 2017
PubMed
Abstract

Insights

Dalbavancin treatment for infective endocarditis (IE) failed in a pregnant patient with methicillin-resistant Staphylococcus aureus (MRSA) IE. Recurrent bacteremia with vancomycin-intermediate (VISA) S. aureus emerged rapidly after treatment.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pharmacology

Background:

  • Limited evidence exists on dalbavancin's efficacy in treating infective endocarditis (IE).
  • Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant challenge in IE management.

Observation:

  • A pregnant patient with MRSA IE and bacteremia received dalbavancin after conventional therapies failed due to non-compliance.
  • Despite initial reduction in vegetation size, the patient experienced recurrent bacteremia with vancomycin-intermediate (VISA) and telavancin-non-susceptible S. aureus within two weeks.

Findings:

  • This case represents the first reported instance of dalbavancin treatment failure in IE.
  • Rapid emergence of VISA and lipoglycopeptide-non-susceptible S. aureus post-dalbavancin treatment was observed.

Implications:

  • The findings raise concerns regarding the use of dalbavancin for IE, particularly in cases involving resistant strains.
  • Further research is needed to evaluate dalbavancin's role and limitations in IE management.
Keywords:
Staphylococcus aureusMRSAbacteremiadalbavancinendocarditispregnancy

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