Daptomycin or Vancomycin Plus Ceftaroline for Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections

Abstract

Recently, one randomized clinical trial (RCT) by Tong et al showed that the addition of an anti-staphylococcal β-lactam to daptomycin or vancomycin alone was not associated with improved the outcome of patients with MRSA bacteremia (1). Moreover, more acute kidney injury occurred in the combination group than monotherapy group in this RCT (1). However, another recent retrospective study by Jorgensen et al which investigated the effect of the addition of a β-lactam to daptomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection and found that the combination of a β-lactam and daptomycin was associated with a better outcome than daptomycin monotherapy (2). Based on the above findings, the clinical outcome of patients with MRSA bacteremia treated by the combination of ceftaroline and vancomycin or daptomycin was similar to those by monotherapy of vancomycin or daptomycin. However, the case and study number are limited in this analysis, further large-scale study is warranted to confirm these findings.