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Vancomycin-Resistant Enterococcus Faecium Prosthetic Valve Endocarditis Treated with Daptomycin and Ampicillin
Anish Krishnan1,2, Irina Rajakumar1, Joanne Salmon3
1Pharmacy Department, Alberta Health Services, Calgary, Alberta, Canada.
Summary
Vancomycin-resistant Enterococcus faecium (VRE) endocarditis is challenging. Combination therapy with daptomycin and ampicillin showed prompt bacteremia clearance but did not prevent mortality in this prosthetic valve endocarditis case.
Area of Science:
- Infectious Diseases
- Cardiology
- Pharmacology
Background:
- Vancomycin-resistant Enterococcus faecium (VRE) infections, particularly bacteremia and infective endocarditis (IE), present significant therapeutic challenges.
- VRE IE is associated with high mortality rates, necessitating exploration of effective treatment strategies.
Observation:
- A case report details a 78-year-old male with VRE prosthetic valve endocarditis.
- The patient was treated with a combination regimen of daptomycin and ampicillin.
Findings:
- Prompt clearance of VRE bacteremia was observed following the combination therapy.
- Despite initial bacteremia control, the patient underwent cardiac valve replacement surgery but experienced post-operative complications and did not survive.
Implications:
- This case contributes to the limited literature on VRE IE treatment, highlighting the potential role of daptomycin and beta-lactam combination therapy.
- While combination therapy may be suitable for select VRE bacteremia and endocarditis cases, treatment failures underscore the need for cautious application and further research.
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