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Staphylococcus aureus
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Some MSSA strains are penicillinase hyperproducers and have a reduced in vitro susceptibility to semisynthetic penicillins. These strains are called borderline oxacillin-resistant Staphylococcus aureus, or BORSA. Oxacillin is used in the microbiology laboratory as a marker for susceptibility to semisynthetic penicillin. Clinically, however, semisynthetic penicillins remain effective against BORSA infections.
Isoxazolyl Penicillins: Oxacillin, Cloxacillin, Dicloxacillin, and Flucloxacillin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Oxacillin occasionally causes fever, nausea, and vomiting associated with abnormal liver function tests, mainly elevated serum glutamic oxaloacetic transaminase (SGOT) levels (Dismukes, 1973; Onorato and Axelrod, 1978). Increases in liver enzymes are seen more commonly (Heldman et al., 1996; Li et al., 2014). Liver biopsy may show a nonspecific hepatitis (Bruckstein and Attia, 1978). Some patients remain asymptomatic and anicteric, the only abnormalities being elevated serum enzymes and sometimes eosinophilia (Olans and Weiner, 1976). Reversible cholestatic hepatitis occurred in one patient (Ten Pas and Quinn, 1965). Liver function abnormalities rapidly disappear when oxacillin is ceased. Hepatotoxicity due to oxacillin appears to be common in HIV-infected patients. In one series, 81% of such patients receiving oxacillin developed liver damage (Saliba and Herbert, 1994). Rash is a frequent accompaniment of oxacillin hepatotoxicity (Maraqa et al., 2002).
Emerging issues on Staphylococcus aureus endocarditis and the role in therapy of daptomycin plus fosfomycin
Published in Expert Review of Anti-infective Therapy, 2023
Cristina García de la Mària, Maria-Alexandra Cañas, Mariana Fernández-Pittol, Anders Dahl, Javier García-González, Marta Hernández-Meneses, Guillermo Cuervo, Asunción Moreno, Jose M. Miró, Francesc Marco
Instead, the European guidelines recommend administering daptomycin at high doses when treating staphylococcal endocarditis and to combine it with other antibiotics such as beta-lactams or fosfomycin for NVE, and with gentamicin or rifampicin, for prosthetic valve endocarditis [39] to overcome the aforementioned disadvantages and improve the clinical outcome of patients. Despite these recommendations, it is important to point out that daptomycin and fosfomycin are not available in some European countries. In the US, intravenous fosfomycin is not yet approved by the FDA. In these cases, the combination of daptomycin plus beta-lactam antibiotics, e.g. cloxacillin or oxacillin or ceftaroline, could be a good option. Thus, there is a continuing need to develop novel more effective antimicrobial agents and to explore strategies that may enhance the potency of existing agents. These include performing pharmacokinetic/pharmacodynamic (PK/PD) modeling studies and the use of combined therapy. In general terms, the treatment of infections caused by S. aureus represents a growing challenge for the health system. Up to now, strategies to manage antibiotic resistance have focused on the use of higher doses, combination treatment, or the development of new antimicrobials agents. Broadly, the rationale of using combination therapy is as follows: provision of wide-spectrum benefits (especially in empiric therapy), acquisition of the synergistic effect, and low risk of emergence of drug-resistant strains (mainly targeted therapy).
Effect of promethazine on biofilms of gram-positive cocci associated with infectious endocarditis
Published in Biofouling, 2023
Gláucia Morgana de Melo Guedes, Carliane Melo Alves Melgarejo, Alyne Soares Freitas, Bruno Rocha Amando, Cecília Leite Costa, Crister José Ocadaque, Francisco Ivanilsom Firmiano Gomes, Silviane Praciano Bandeira, Rossana de Aguiar Cordeiro, Marcos Fábio Gadelha Rocha, José Júlio Costa Sidrim, Débora de Souza Collares Maia Castelo-Branco
The American Heart Association (AHA) estimates that about 100,000 to 200,000 new cases of infective endocarditis are diagnosed in the United States of America (USA) each year, and recent data showing an increase in incidence in USA and UK (Yang et al. 2015; Hubers et al. 2020). Endocarditis is usually caused by an infection, where an endothelial cardiovascular presents an inflammatory structure of platelets and fibrin commonly observed with growth of vegetations composed of microorganisms, which can be considered a pathognomonic sign of the disease (Cahill and Prendergast 2016; Pecoraro and Doubell 2020). The main etiological agents are Gram-positive cocci, with emphasis on the genera Staphylococcus spp. and Streptococcus spp. (Htwe and Khardori 2012). To treat the infection, several drug regimens can be used, most of which include oxacillin or vancomycin against Staphylococcus spp. and ceftriaxone or vancomycin against Streptococcus spp., with vancomycin as the last drug resource (Gould et al. 2012; Habib et al. 2015).
Role of dalbavancin as combination therapy: evidence from the literature and clinical scenarios
Published in Expert Review of Anti-infective Therapy, 2022
Bruno Cacopardo, Dario Cattaneo, Francesco Cortese, Mariagrazia Di Luca, Marco Falcone, Giulia Marchetti, Carlo Tascini, Giusy Tiseo, Mario Venditti
Several in vitro studies showed a synergistic activity of lipopeptide and glycopeptide antibiotics combined with beta-lactams [17–19]. Since its approval, several in vitro studies also demonstrated the synergy between dalbavancin and other antibiotics [20]. Importantly, a synergistic effect with oxacillin was observed against staphylococci, including MRSA, vancomycin-intermediate Staphylococcus aureus (VISA), and enterococci, findings with potential clinical implications. Of importance, dalbavancin displays potent in vitro synergistic activity with other antistaphylococcal antibiotics, such as ceftaroline [21,22]. Dalbavancin MICs significantly decrease in combination with cefazolin, ceftaroline, and oxacillin against MRSA, hVISA, VISA, and linezolid-resistant S. aureus isolates [21]. The combination of dalbavancin plus linezolid against MRSA isolates is highly synergistic with no antagonistic effect [23].