Endocarditis due to vancomycin-resistant Enterococcus faecium in an immunocompromised patient: cure by administering combination therapy with quinupristin/dalfopristin and high-dose ampicillin

South Med J. 2003 Aug;96(8):818-20. doi: 10.1097/01.SMJ.0000047962.61701.57.

Abstract

A 56-year-old man with diabetes mellitus and cadaveric renal transplantation had vancomycin-resistant Enterococcus faecium tricuspid valve endocarditis. Relapse followed 6 weeks of treatment with intravenous gentamicin and high-dose ampicillin. On the basis of previous data suggesting the potential for synergistic activity of quinupristin/dalfopristin plus high-dose ampicillin, therapy with this combination was administered for 63 days. Cure was achieved and later confirmed at 2-year follow-up.

Publication types

  • Case Reports

MeSH terms

  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / immunology
  • Bacteremia / microbiology*
  • Diabetes Mellitus, Type 1 / complications
  • Drug Resistance, Bacterial
  • Drug Therapy, Combination / therapeutic use
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / immunology
  • Endocarditis, Bacterial / microbiology*
  • Enterococcus faecium*
  • Gentamicins / therapeutic use
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / immunology
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Immunocompromised Host* / immunology
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Penicillins / therapeutic use
  • Recurrence
  • Treatment Outcome
  • Vancomycin Resistance*
  • Virginiamycin / analogs & derivatives*
  • Virginiamycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Penicillins
  • Virginiamycin
  • quinupristin
  • Ampicillin
  • dalfopristin