In vitro testing of daptomycin plus rifampin against methicillin-resistant Staphylococcus aureus resistant to rifampin. 2008

Faisal A Khasawneh, and Deborah S Ashcraft, and George A Pankey
Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan, and formerly of Tulane Health Sciences Center, New Orleans, Louisiana, United States of America.

OBJECTIVE To test for synergy between daptomycin (DAP) and rifampin (RIF) against RIF-resistant methicillin-resistant Staphylococcus aureus (MRSA) isolates. METHODS Synergy testing using time-kill assay (TKA) was performed on 6 clinically, and genetically unique RIF-resistant MRSA isolates. The isolates were identified out of 489 (1.2%) samples collected during April 2003 to August 2006, from patients at the Ochsner Medical Center in New Orleans, Louisiana, United States of America. RESULTS Synergy testing of DAP plus RIF by TKA showed that 5 isolates were indifferent, but one isolate was antagonistic. CONCLUSIONS Our in vitro study failed to demonstrate synergy between DAP plus RIF, against our RIF-resistant MRSA isolates. Clinical failure of this combination should prompt the clinician to consider antagonism, as one of the potential causes.

UI MeSH Term Description Entries
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D012293 Rifampin A semisynthetic antibiotic produced from Streptomyces mediterranei. It has a broad antibacterial spectrum, including activity against several forms of Mycobacterium. In susceptible organisms it inhibits DNA-dependent RNA polymerase activity by forming a stable complex with the enzyme. It thus suppresses the initiation of RNA synthesis. Rifampin is bactericidal, and acts on both intracellular and extracellular organisms. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p1160) Rifampicin,Benemycin,Rifadin,Rimactan,Rimactane,Tubocin
D013203 Staphylococcal Infections Infections with bacteria of the genus STAPHYLOCOCCUS. Infections, Staphylococcal,Staphylococcus aureus Infection,Staphylococcal Infection,Staphylococcus aureus Infections
D017576 Daptomycin A cyclic lipopeptide antibiotic that inhibits GRAM-POSITIVE BACTERIA. Cubicin,Daptomycin, 9-L beta-Aspartic Acid,Deptomycin,LY-146032,Daptomycin, 9 L beta Aspartic Acid,LY 146032,LY146032
D055624 Methicillin-Resistant Staphylococcus aureus A strain of Staphylococcus aureus that is non-susceptible to the action of METHICILLIN. The mechanism of resistance usually involves modification of normal or the presence of acquired PENICILLIN BINDING PROTEINS. MRSA,Methicillin Resistant Staphylococcus aureus

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