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- Title
Should daptomycin-rifampin combinations for MSSA/MRSA isolates be avoided because of antagonism?
- Authors
Stein, C.; Makarewicz, O.; Forstner, C.; Weis, S.; Hagel, S.; Löffler, B.; Pletz, M.
- Abstract
Purpose: There is increasing clinical evidence from observational studies, that combination therapy of daptomycin with rifampin is a valuable treatment option for biofilm-associated difficult to treat Staphylococcus aureus infections such as osteomyelitis, prosthetic joint infection and endocarditis. However, two studies analyzing a limited number of S. aureus isolates reported an antagonism of those two drugs questioning the benefit of this combination. Methods: To estimate the frequency of this possible antagonism, we performed in vitro checkerboard assays on 58 consecutive clinical isolates of S. aureus (MSSA n = 9, MRSA n = 49). We determined the fractional inhibitory concentration index (FICI) and the susceptible breakpoint index (SBPI). All isolates were characterized by a microprobe array detecting 336 different genes/alleles to ensure their non-clonal origin. Results: For all isolates, the FICI was between 1.00 and 1.25 indicating additive effects for the daptomycin/rifampin combination. Neither antagonism nor synergism as defined by the FICI was found for any of the isolates. Conclusion: Based on these data, there is no evidence to advise against the daptomycin/rifampin combination therapy.
- Subjects
RIFAMPIN; PEPTIDE antibiotics; BIOLOGICAL assay; CELL culture; COMBINATION drug therapy; DRUG antagonism; STAPHYLOCOCCUS aureus; METHICILLIN-resistant staphylococcus aureus; IN vitro studies; THERAPEUTICS
- Publication
Infection, 2016, Vol 44, Issue 4, p499
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-016-0874-2