Clinical Outcome with Oral Linezolid and Rifampin Following Recurrent Methicillin-Resistant<i>Staphylococcus aureus</i>Bacteremia Despite Prolonged Vancomycin Treatment

Drug-resistant Gram-positive bacteria, especiallyStaphylococcus aureus, are emerging as the predominant organisms involved in both nosocomial and community-acquired infections. Since the 1980s, vancomycin has been the first-line antibiotic used to treat methicillin-resistantS aureus. However, allergy and intolerance to vancomycin, the increasing number of vancomycin clinical failures and the existence of vancomycin intermediate-susceptible isolates ofS aureussuggest that new antibiotics are needed. This paper reports the only known case of a successful clinical outcome with long term oral linezolid and rifampin therapy in the management of recurrent and persistent methicillin-resistantS aureusbacteremia with metastatic infections despite prolonged vancomycin use. More than two years since the initiation of linezolid and rifampin, the study patient has been clinically well with no evidence of adverse drug reactions including cytopenia and hepatic toxicities. Physicians must be aware of the novel developments in antibiotic therapy to treat drug-resistant bacterial infections.

Clinical Outcome with Oral Linezolid and Rifampin Following Recurrent Methicillin-ResistantStaphylococcus aureusBacteremia Despite Prolonged Vancomycin Treatment Journal Articles