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linezolid daptomycin VRE

E-M Klupp, A Both, C Belmar Campos, H Büttner, C König, M Christopeit, M Christner, M Aepfelbacher, H Rohde
Vancomycin-resistant enterococci (VRE) are of ever-increasing importance, most notably in high-risk patient populations. Therapy options are often limited for these isolates, and apart from tigecycline and daptomycin, oxazolidinone linezolid is frequently administered. The broad usage of linezolid, however, has driven the emergence of linezolid-resistant VRE strains (LR-VRE), further shortening therapeutic options. Second-generation oxazolidinone tedizolid has the advantage of being active against a specific subset of LR-VRE, i...
August 15, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Ming Zhao, Liang Liang, Liwei Ji, Di Chen, Yatong Zhang, Yuanchao Zhu, Khilna Patel
Daptomycin and linezolid are the most commonly used antibiotics for bloodstream infection caused by vancomycin-resistant enterococci (VRE-BSI). However, the best therapeutic agent to treat VRE-BSI remains to be established. In order to provide evidence for an optimal treatment decision, a systematic review and meta-analysis was performed comparing the efficacy and safety of daptomycin and linezolid for the treatment of VRE-BSI. After thorough searching of relevant studies from MEDLINE, EMBASE, Clinicaltrials...
September 2016: International Journal of Antimicrobial Agents
Yu-Chung Chuang, Hsin-Yi Lin, Pao-Yu Chen, Chi-Ying Lin, Jann-Tay Wang, Shan-Chwen Chang
OBJECTIVES: Treatment options for vancomycin-resistant enterococcus (VRE) bloodstream infection (BSI) are limited. Studies comparing daptomycin or linezolid in treating VRE-BSI have conflicting results and suggest daptomycin underdosing. The responses to different daptomycin doses have not been studied. METHODS: We conducted a multicenter prospective cohort study to compare linezolid and daptomycin (≥6 mg/kg) for the treatment of VRE-BSI. The primary outcome was 14-day mortality...
July 27, 2016: Clinical Microbiology and Infection
Nicholas S Britt, Emily M Potter
This study aimed to evaluate the clinical outcomes of vancomycin-resistant enterococcal bloodstream infections (VRE BSI) caused by Enterococcus gallinarum or Enterococcus casseliflavus. Variables associated with treatment failure were determined and treatment options were compared. This was a national retrospective study of hospitalised Veterans Affairs patients with non-faecium, non-faecalis VRE BSI. The primary outcome was treatment failure, defined as a composite of: (i) 30-day all-cause mortality; (ii) microbiological failure; and (iii) 30-day VRE BSI recurrence...
June 2016: Journal of Global Antimicrobial Resistance
Christina Forstner, Mathias W Pletz
Infections with multi-drug resistant bacteria are increasing worldwide. Glycopeptides, linezolid, daptomycin and 5th generation cephalosporins ("MRSA-cephalsoporins") are used against severe infections with MRSA, combination partners are rifampin and fosfomycin. Treatment options against VRE-infections are limited to linezolid, daptomycin and tigecyclin. New agents with activity against MRSA and VRE are tedizolid, dalbvancin and oritavancin. For monotherapy of severe infections due to 3MRGN carbapenems are available...
February 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Chunjiang Zhao, Hongbin Chen, Hui Wang, Wenen Liu, Chao Zhuo, Yunzhuo Chu, Ji Zeng, Yan Jin, Zhidong Hu, Rong Zhang, Bin Cao, Kang Liao, Bijie Hu, Xiuli Xu, Yanping Luo, Mingxiang Zou, Danhong Su, Yong Wang, Bin Tian, Hongwei Zhou, Yingmei Liu, Penghao Guo, Chunmei Zhou, Xiao Chen, Zhanwei Wang, Feifei Zhang
OBJECTIVE: To investigate the spectrum and antimicrobial resistance of major pathogensthat causing nosocomial infections in China, 2013. METHODS: Nosocomial cases as well as pathogens causing bloodstream infections (BSI), hospital-acquired pneumonia (HAP) and intra-abdominal infections (IAI) from 13 teaching hospital around China were collected. The minimum inhibitory concentrations (MICs) were determined by the agar dilution method. The CLSI M100-S23 criteria were used for interpretation...
June 9, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Jennifer A Johnson, Eoin R Feeney, David W Kubiak, G Ralph Corey
Oritavancin is a novel lipoglycopeptide with activity against Gram-positive organisms including streptococci, methicillin-resistant Staphylococcus aureus, vancomycin-resistant S aureus (VRSA), and vancomycin-resistant enterococci (VRE) [1-3]. The US Food and Drug Administration approved oritavancin as a single intravenous dose of 1200 mg for the treatment of acute bacterial skin and skin structure infections on the basis of 2 clinical trials demonstrating noninferiority compared with vancomycin [4, 5]. There are limited options for treatment of serious VRE infections...
December 2015: Open Forum Infectious Diseases
Katie E Barber, Jordan R Smith, Animesh Raut, Michael J Rybak
OBJECTIVES: Tedizolid displays potent activity against Gram-positive pathogens. In vitro studies against clinical isolates of Staphylococcus aureus and enterococci demonstrated improved tedizolid activity over linezolid. However, this is not well-characterized against a large collection of resistant isolates, including vancomycin-intermediate S. aureus (VISA), heterogeneous VISA (hVISA), daptomycin-non-susceptible (DNS) S. aureus, linezolid-resistant (LR) S. aureus and VRE. Therefore, our objective was to determine tedizolid activity versus other agents, against MRSA and VRE with various resistance phenotypes...
January 2016: Journal of Antimicrobial Chemotherapy
Chang-Ro Lee, Jung Hun Lee, Kwang Seung Park, Byeong Chul Jeong, Sang Hee Lee
The increase of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) poses a worldwide and serious health threat. Although new antibiotics, such as daptomycin and linezolid, have been developed for the treatment of infections of Gram-positive pathogens, the emergence of daptomycin-resistant and linezolid-resistant strains during therapy has now increased clinical treatment failures. In the past few years, studies using quantitative proteomic methods have provided a considerable progress in understanding antibiotic resistance mechanisms...
2015: Frontiers in Microbiology
Nicholas S Britt, Emily M Potter, Nimish Patel, Molly E Steed
BACKGROUND: Vancomycin-resistant Enterococcus bloodstream infections (VRE-BSIs) are becoming increasingly common. Linezolid and daptomycin are the primary treatment options for VRE-BSI, but optimal treatment is unclear. METHODS: This was a national retrospective cohort study comparing linezolid and daptomycin for the treatment of VRE-BSI among Veterans Affairs Medical Center patients admitted during 2004-2013. The primary outcome was treatment failure, defined as a composite of (1) 30-day all-cause mortality; (2) microbiologic failure; and (3) 60-day VRE-BSI recurrence...
September 15, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
P J Simner, H Adam, M Baxter, M McCracken, G Golding, J A Karlowsky, K Nichol, P Lagacé-Wiens, M W Gilmour, D J Hoban, G G Zhanel
Of 1,927 Enterococcus species isolates collected across Canada from 2007 to 2013, 80 (4.2%) were identified as vancomycin-resistant enterococci (VRE). VRE infections during this time tripled in Canadian hospitals, from 1.8% to 6.0% (P = 0.03). All VRE were Enterococcus faecium, with 90% possessing vanA. The prevalence of vanB decreased from 37.5% in 2007 to 0% in 2013 (P < 0.05). The VRE were multidrug resistant, but 70.6%, 86.3%, and 100% were susceptible to doxycycline, linezolid, and daptomycin, respectively...
July 2015: Antimicrobial Agents and Chemotherapy
Elizabeth Short, John Esterly, Michael Postelnick, Jeannie Ong, Milena McLaughlin
Vancomycin resistant Enterococcus (VRE) colonized patients are likely to receive VRE targeted Gram-positive antibiotics and may not be de-escalated appropriately once final cultures are available. A retrospective cohort study was conducted in VRE-colonized and non-VRE colonized patients with Enterococcal bloodstream infections. Of 101 patients (n = 50 VRE-colonized; n = 51 non-colonized), empiric therapy with linezolid or daptomycin was started more often in VRE-colonized than non-colonized patients (n = 8, 15...
2014: Antimicrobial Resistance and Infection Control
Katie E Barber, S Travis King, Kayla R Stover, Jason M Pogue
Enterococcal infections are relatively common among hospitalized patients, likely because these organisms are commensals of human gastrointestinal and genitourinary tracts. With widespread usage of glycopeptides in both humans and livestock, vancomycin-resistant enterococci (VRE) quickly emerged. Bloodstream infections caused by these isolates are of significant concern with limited bactericidal options for treatment. Presently, daptomycin and linezolid serve as the mainstays of therapy, although resistance to both agents has been documented...
March 2015: Expert Review of Anti-infective Therapy
Nico T Mutters, Guido Werner, Evelina Tacconelli, Alexander Mischnik
Complicated infections caused by vancomycin-resistant enterococci (VRE) represent a therapeutic challenge, since adequate treatment options are limited and antibiotic resistance to the available agents has already been described. The most frequently used antibiotic in VRE treatment is linezolid. Tigecycline is an alternative to linezolid, however, clinical data for severe infections such as sepsis or endocarditis are scarce. Daptomycin on the one hand is an option but has not yet been approved for the treatment of enterococcal infections in Germany on the other hand...
January 2015: Deutsche Medizinische Wochenschrift
An-Jing Kuo, Lin-Hui Su, Jwu-Ching Shu, Jann-Tay Wang, Jen-Hsien Wang, Chang-Phone Fung, Ju-Hsin Chia, Jang-Jih Lu, Tsu-Lan Wu
Cases of bacteremia caused by vancomycin-resistant E. faecium (VRE-fm) increased significantly in Taiwan. The present multicenter surveillance study was performed to reveal the associated epidemiological characteristics. In 2012, 134 non-repetitive VRE-fm isolates were prospectively collected from 12 hospitals in Taiwan. Antimicrobial susceptibility, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and analysis of van genes and Tn1546 structures were investigated. Two isolates carried vanB genes, while all the remaining isolates carried vanA genes...
2014: PloS One
Yu-Chung Chuang, Jann-Tay Wang, Hsin-Yi Lin, Shan-Chwen Chang
BACKGROUND: Linezolid, which has bacteriostatic activity, is approved for the treatment of vancomycin-resistant enterococci (VRE) infections. Meanwhile, daptomycin exerts bactericidal activity against VRE, but is not approved for the treatment of VRE bacteremia. Only a few studies with small sample sizes have compared the effectiveness of these drugs for treatment of VRE bacteremia. METHODS: PubMed, EMBASE, and the Cochrane Library were searched for studies of VRE bacteremia treatment published before January 1, 2014...
2014: BMC Infectious Diseases
Ruchi Patel, Jason C Gallagher
OBJECTIVE: To review the literature on the pharmacotherapy of bloodstream infections (BSI) caused by vancomycin-resistant enterococci (VRE). DATA SOURCES: A MEDLINE literature search was performed for the period 1946 to May 2014 using the search terms Enterococcus, enterococci, vancomycin-resistant, VRE, bacteremia, and bloodstream infection. References were also identified from selected review articles. STUDY SELECTION AND DATA EXTRACTION: English-language case series, cohort studies, and meta-analyses assessing the options in the pharmacotherapy of VRE BSIs in adult patients were evaluated...
January 2015: Annals of Pharmacotherapy
Pranita D Tamma, Alice J Hsu
PURPOSE OF REVIEW: Uncertainties exist regarding the optimal treatment for vancomycin-resistant enterococcal (VRE) bloodstream infections, particularly in settings in which ampicillin cannot be used. RECENT FINDINGS: Quinupristin-dalfopristin, linezolid, and daptomycin, all approved between 1999 and 2003, represent the mainstays of therapy for VRE bacteremia, although only linezolid has been specifically approved by the United States Food and Drug Administration for this indication...
December 2014: Current Opinion in Infectious Diseases
Vincent C C Cheng, Jonathan H K Chen, Josepha W M Tai, Sally C Y Wong, Rosana W S Poon, Ivan F N Hung, Kelvin K W To, Jasper F W Chan, Pak-Leung Ho, Chung-Mau Lo, Kwok-Yung Yuen
BACKGROUND: Prolonged asymptomatic carriage of vancomycin-resistant enterococci (VRE) in the gastrointestinal tract and the lack of effective decolonization regimen perpetuate the endemicity of VRE in the healthcare settings. CASE PRESENTATION: We report a regimen for decolonization of gastrointestinal carriage of VRE by a combination of environmental disinfection, patient isolation, bowel preparation to wash-out the fecal bacterial population using polyethylene glycol, a five-day course of oral absorbable linezolid and non-absorbable daptomycin to suppress any remaining VRE, and subsequent oral Lactobacillus rhamnosus GG to maintain the colonization resistance in four patients, including two patients with end-stage liver cirrhosis, one patient with complication post liver transplant, and one patient with complicated infective endocarditis...
2014: BMC Infectious Diseases
Sandra Rincón, Diana Panesso, Lorena Díaz, Lina P Carvajal, Jinnethe Reyes, José M Munita, César A Arias
New therapeutic alternatives have been developed in the last years for the treatment of multidrug-resistant Gram-positive infections. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are considered a therapeutic challenge due to failures and lack of reliable antimicrobial options. Despite concerns related to the use of vancomycin in the treatment of severe MRSA infections in specific clinical scenarios, there is a paucity of solid clinical evidence that support the use of alternative agents (when compared to vancomycin)...
April 2014: Biomédica: Revista del Instituto Nacional de Salud
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