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RP59500 (Quinupristin/dalfopristin): three case reports of its use in infection due to Enterococcus faecium
J Cassell1, I Balakrishnan, D Samarasinghe
1Department of Medical Microbiology, Royal Free Hospital School of Medicine, London, UK.
Abstract:
We describe three cases of Enterococcus faecium sepsis arising in immunocompromised patients, severely ill with other conditions, who were treated with the new injectable streptogramin RP59500. There are still few reports of clinical experience with this drug. All had bacteriological resolution, with one patient recovering fully. Although two of the three patients died, this was due to underlying disease in one case and a gram-negative superinfection in another. Quinupristin/dalfopristin therapy was not associated with significant adverse effects in any of the patients.
Insights
New streptogramin antibiotic quinupristin/dalfopristin showed bacteriological resolution in three immunocompromised patients with Enterococcus faecium sepsis. While not causing adverse effects, patient survival depended on underlying conditions and secondary infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Enterococcus faecium sepsis poses a significant threat, particularly in immunocompromised patients with severe underlying illnesses.
- Limited clinical data exists for novel antimicrobial agents like the injectable streptogramin RP59500 (quinupristin/dalfopristin).
Observation:
- Three severely ill, immunocompromised patients with Enterococcus faecium sepsis were treated with quinupristin/dalfopristin.
- Clinical monitoring and follow-up were conducted to assess treatment efficacy and safety.
Findings:
- All three patients achieved bacteriological resolution of Enterococcus faecium sepsis following quinupristin/dalfopristin therapy.
- One patient experienced a full clinical recovery.
- Two patients died; one from their underlying critical illness and the other from a secondary Gram-negative bacterial superinfection.
Implications:
- Quinupristin/dalfopristin demonstrates potential for treating Enterococcus faecium sepsis, achieving microbiological cure.
- The drug was well-tolerated, with no significant adverse effects observed.
- Patient outcomes highlight the critical role of host factors and prevention of secondary infections in critically ill patients receiving novel antibiotics.