INTENSIVIST Volume 11, Issue 1 (January 2019)

Treatment of severe Staphylococcus aureus bacteremia Hirotada KOBAYASHI 1 , Yoshiro HAYASHI 2 1Department of General Medicine Kameda Medical Center 2Department of Intensive Care Medicine Kameda Medical Center pp.3-19
Published Date 2019/1/1
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Staphylococcus aureus bacteremia is a critical illness with high mortality, especially for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Intensivists sometimes have difficulty treating patients with severe Staphylococcus aureus bacteremia even today. The main antibiotics used against methicillin-sensitive Staphylococcus aureus (MSSA), such as oxacillin, nafcillin and cloxacillin, are not approved in Japan. Therefore, anti-MRSA drugs with insufficient evidence for use in critically ill patients are given. Current first-choice antibiotics in Japan include cefazolin for MSSA and vancomycin for MRSA. Prescribing daptomycin for persistent MRSA bacteremia despite adequate vancomycin therapy or MRSA bacteremia with minimum inhibitor concentration of vancomycin > 2 mcg/mL must be considered. Investigators are now conducting clinical studies of combination therapy with vancomycin and beta-lactam antibiotics for MRSA bacteremia. Several case reports and studies of other combination therapies for persistent MRSA bacteremia have been reported. The important factor to decide the therapeutic duration to treat Staphylococcus aureus bacteremia is uncomplicated or complicated. Researchers are investigating treatment courses less than two weeks in patients with uncomplicated Staphylococcus aureus bacteremia. An infectious disease consultation for patients with Staphylococcus aureus bacteremia is recommended to improve overall management and outcomes.

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11巻1号 (2019年1月)
電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル