J M Steele1,2, R W Seabury1, C M Hale3, B T Mogle1. 1. Department of Pharmacy, State University of New York Upstate Medical University - University Hospital, Syracuse, NY, USA. 2. Department of Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA. 3. Department of Pharmacy, Penn State Milton S Hershey Medical Center, Hershey, PA, USA.
Abstract
WHAT IS KNOWN AND OBJECTIVE: Limited evidence describes dalbavancin use in infective endocarditis (IE). CASE DESCRIPTION: A 27-year-old pregnant female received 4 weeks of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and tricuspid valve IE after conventional therapy was no longer an option due to non-compliance. Despite having a smaller cardiac vegetation following dalbavancin, she was bacteraemic <2 weeks later with vancomycin-intermediate (VISA) and telavancin-non-susceptible S. aureus. WHAT IS NEW AND CONCLUSION: This is the first report of unsuccessful IE treatment with dalbavancin. Blood cultures grew VISA and lipoglycopeptide-non-susceptible S. aureus <2 weeks following dalbavancin. Both outcomes raise concerns about using dalbavancin for IE.
WHAT IS KNOWN AND OBJECTIVE: Limited evidence describes dalbavancin use in infective endocarditis (IE). CASE DESCRIPTION: A 27-year-old pregnant female received 4 weeks of dalbavancin for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and tricuspid valve IE after conventional therapy was no longer an option due to non-compliance. Despite having a smaller cardiac vegetation following dalbavancin, she was bacteraemic <2 weeks later with vancomycin-intermediate (VISA) and telavancin-non-susceptible S. aureus. WHAT IS NEW AND CONCLUSION: This is the first report of unsuccessful IE treatment with dalbavancin. Blood cultures grew VISA and lipoglycopeptide-non-susceptible S. aureus <2 weeks following dalbavancin. Both outcomes raise concerns about using dalbavancin for IE.
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