Infect Chemother.  2022 Dec;54(4):797-802. 10.3947/ic.2022.0106.

Successful Treatment of VancomycinResistant Enterococcus species Bone and Joint Infection with Daptomycin Plus Beta Lactam Agents

• La YJ
• Kim YC

• KMID: 2537717
• DOI: http://doi.org/10.3947/ic.2022.0106

Abstract

Bone and joint infections (BJI) caused by vancomycin-resistant Enterococcus spp. (VRE) are difficult to treat due to limited antibiotic options. Although linezolid can be used for VRE treatment, it is often discontinued due to time-dependent bone marrow suppression. Daptomycin, a lipopeptide antibiotic agent with rapid bactericidal activity, is another available therapeutic option for VRE infections. We report a case of VRE BJI successfully treated with a high dose of daptomycin plus β-lactam agents. An 84-year-old man received linezolid for the treatment of VRE BJI. After 2 weeks of therapy, the patient experienced bleeding events associated with linezolid-induced bone marrow toxicity and linezolid was discontinued. Next, high-dose daptomycin therapy combined with a β-lactam agent was selected to treat the remaining VRE BJI. During daptomycin treatment, microbiological eradication was achieved, and the patient clinically improved without evidence of adverse events. We highlight the need for daptomycin use for the treatment of VRE infections, especially in cases where linezolid is ineffective

Keyword

Enterococcus spp; Daptomycin; Bone and joint infection