Ceftaroline in the treatment of methicillin-resistant and daptomycin-non-susceptible Staphylococcus aureus bacteremia and infective endocarditis in end-stage renal disease

Abstract

As bacteria evolve and become resistant to preferred antibiotics, we often have toresort to alternative, second-line agents for treatment. This case highlights a growingtrend being observed among methicillin-resistant Staphylococcus aureus (MRSA)isolates, in which the minimum inhibitory concentration breakpoints start to increaseand traditional therapy fails. When clinicians are faced with a difficult to treat infectionand constrained by declining renal function, drug allergies, or clinical scenario, it maybe prudent to use therapy that is supported by only in vitro data, animal models, andstrong case reports. Combining knowledge of the drug’s kinetic properties, mechanismof action, safety, and adverse effect profile, and literature to support its use helpedguide our decision in treating a patient with persistent MRSA bacteremia and infectiveendocarditis.