What do beta-lactams add to vancomycin or daptomycin in the treatment of patients with methicillin-resistant Staphylococcus aureus bacteraemia? A review
Several studies have documented the synergy between vancomycin/daptomycin and various beta-lactams, and clinical studies have studied this combination therapy in humans. We review the published literature on this topic to know the utility of the combined treatment with beta-lactams in treating bacte...
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| Veröffentlicht in: | Postgraduate medical journal 2022-01, Vol.98 (1155), p.48-56 |
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| creator | García Aragonés, Laura Blanch Sancho, José Javier Segura Luque, Juan Carlos Mateos Rodriguez, Fernando Martínez Alfaro, Elisa Solís García del Pozo, Julián |
| description | Several studies have documented the synergy between vancomycin/daptomycin and various beta-lactams, and clinical studies have studied this combination therapy in humans. We review the published literature on this topic to know the utility of the combined treatment with beta-lactams in treating bacteraemia methicillin-resistant Staphylococcus aureus (MRSA) infections. Fifteen observational studies, three randomised clinical trials and three systematics reviews are analysed in this article. Observational studies used ceftaroline, cefazolin, piperacillin/tazobactam or cefepime among the beta-lactams. Clinical trials used cloxacillin or flucloxacillin as the most used beta-lactam in two trials and ceftaroline in one. Three systematic reviews are published. One of them only includes studies with vancomycin and included six studies. The other two systematic reviews include patients with daptomycin or vancomycin and included 15 and 9 studies, respectively. Adding a beta-lactam to vancomycin or daptomycin may help shorten bacteraemia and avoid recurrences in patients with MRSA bacteraemia. There is no evidence that combined therapy improves mortality. Nephrotoxicity in clinical trials precludes the use of combination therapy mainly with cloxacillin or flucloxacillin, but systematic reviews have not found a significant difference in this point in observational studies with other beta-lactams. The role of other beta-lactams such as ceftaroline should be thoroughly studied in these patients. |
| doi_str_mv | 10.1136/postgradmedj-2020-139512 |
| format | Article |
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A review</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><creator>García Aragonés, Laura ; Blanch Sancho, José Javier ; Segura Luque, Juan Carlos ; Mateos Rodriguez, Fernando ; Martínez Alfaro, Elisa ; Solís García del Pozo, Julián</creator><creatorcontrib>García Aragonés, Laura ; Blanch Sancho, José Javier ; Segura Luque, Juan Carlos ; Mateos Rodriguez, Fernando ; Martínez Alfaro, Elisa ; Solís García del Pozo, Julián</creatorcontrib><description>Several studies have documented the synergy between vancomycin/daptomycin and various beta-lactams, and clinical studies have studied this combination therapy in humans. We review the published literature on this topic to know the utility of the combined treatment with beta-lactams in treating bacteraemia methicillin-resistant Staphylococcus aureus (MRSA) infections. Fifteen observational studies, three randomised clinical trials and three systematics reviews are analysed in this article. Observational studies used ceftaroline, cefazolin, piperacillin/tazobactam or cefepime among the beta-lactams. Clinical trials used cloxacillin or flucloxacillin as the most used beta-lactam in two trials and ceftaroline in one. Three systematic reviews are published. One of them only includes studies with vancomycin and included six studies. The other two systematic reviews include patients with daptomycin or vancomycin and included 15 and 9 studies, respectively. Adding a beta-lactam to vancomycin or daptomycin may help shorten bacteraemia and avoid recurrences in patients with MRSA bacteraemia. There is no evidence that combined therapy improves mortality. Nephrotoxicity in clinical trials precludes the use of combination therapy mainly with cloxacillin or flucloxacillin, but systematic reviews have not found a significant difference in this point in observational studies with other beta-lactams. The role of other beta-lactams such as ceftaroline should be thoroughly studied in these patients.</description><identifier>ISSN: 0032-5473</identifier><identifier>EISSN: 1469-0756</identifier><identifier>DOI: 10.1136/postgradmedj-2020-139512</identifier><identifier>PMID: 33563707</identifier><language>eng</language><publisher>England: The Fellowship of Postgraduate Medicine</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacteremia - drug therapy ; beta-Lactams - therapeutic use ; Clinical outcomes ; Cloxacillin - therapeutic use ; Daptomycin - therapeutic use ; Drug resistance ; Floxacillin - therapeutic use ; Humans ; Methicillin-Resistant Staphylococcus aureus - drug effects ; Methicillin-Resistant Staphylococcus aureus - isolation & purification ; Mortality ; Penicillin ; Review ; Staphylococcal Infections - drug therapy ; Staphylococcus infections ; Vancomycin - therapeutic use</subject><ispartof>Postgraduate medical journal, 2022-01, Vol.98 (1155), p.48-56</ispartof><rights>Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. 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A review</atitle><jtitle>Postgraduate medical journal</jtitle><stitle>Postgrad Med J</stitle><addtitle>Postgrad Med J</addtitle><date>2022-01-01</date><risdate>2022</risdate><volume>98</volume><issue>1155</issue><spage>48</spage><epage>56</epage><pages>48-56</pages><issn>0032-5473</issn><eissn>1469-0756</eissn><abstract>Several studies have documented the synergy between vancomycin/daptomycin and various beta-lactams, and clinical studies have studied this combination therapy in humans. We review the published literature on this topic to know the utility of the combined treatment with beta-lactams in treating bacteraemia methicillin-resistant Staphylococcus aureus (MRSA) infections. Fifteen observational studies, three randomised clinical trials and three systematics reviews are analysed in this article. Observational studies used ceftaroline, cefazolin, piperacillin/tazobactam or cefepime among the beta-lactams. Clinical trials used cloxacillin or flucloxacillin as the most used beta-lactam in two trials and ceftaroline in one. Three systematic reviews are published. One of them only includes studies with vancomycin and included six studies. The other two systematic reviews include patients with daptomycin or vancomycin and included 15 and 9 studies, respectively. Adding a beta-lactam to vancomycin or daptomycin may help shorten bacteraemia and avoid recurrences in patients with MRSA bacteraemia. There is no evidence that combined therapy improves mortality. Nephrotoxicity in clinical trials precludes the use of combination therapy mainly with cloxacillin or flucloxacillin, but systematic reviews have not found a significant difference in this point in observational studies with other beta-lactams. The role of other beta-lactams such as ceftaroline should be thoroughly studied in these patients.</abstract><cop>England</cop><pub>The Fellowship of Postgraduate Medicine</pub><pmid>33563707</pmid><doi>10.1136/postgradmedj-2020-139512</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8361-2090</orcidid></addata></record> |
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| ispartof | Postgraduate medical journal, 2022-01, Vol.98 (1155), p.48-56 |
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| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE |
| subjects | Anti-Bacterial Agents - therapeutic use Antibiotics Bacteremia - drug therapy beta-Lactams - therapeutic use Clinical outcomes Cloxacillin - therapeutic use Daptomycin - therapeutic use Drug resistance Floxacillin - therapeutic use Humans Methicillin-Resistant Staphylococcus aureus - drug effects Methicillin-Resistant Staphylococcus aureus - isolation & purification Mortality Penicillin Review Staphylococcal Infections - drug therapy Staphylococcus infections Vancomycin - therapeutic use |
| title | What do beta-lactams add to vancomycin or daptomycin in the treatment of patients with methicillin-resistant Staphylococcus aureus bacteraemia? A review |
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