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Intensive Care Med. 2002 Aug;28(8):1157-60. Epub 2002 Jun 20.

Clinical experience with quinupristin-dalfopristin as rescue treatment of critically ill patients infected with methicillin-resistant staphylococci.

Author information

1
Abteilung für Anästhesiologie und Intensivmedizin, Evangelisches und Johanniter Klinikum, Fahrner Strasse 133-135, 47169 Duisburg, Germany. andreas.sander@ejk.de

Abstract

OBJECTIVES:

To describe the efficacy and safety of quinupristin-dalfopristin (Q-D) as rescue therapy in critically ill patients with severe infections caused by methicillin-resistant staphylococci unresponsive to vancomycin treatment.

DESIGN:

Observational study in the context of the compassionate use programme for Q-D.

METHODS:

Twelve mechanically ventilated patients suffering from severe staphylococcal infections, pretreated unsuccessfully with vancomycin despite in vitro sensitivity, were included. Patients received, intravenously, Q-D 7.5 mg/kg body weight 3 times daily. The duration of Q-D therapy averaged 11.8 days (range: 1-26 days). The outcome variables were clinical efficacy and bacteriological eradication.

RESULTS:

Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) were isolated in three patients each, and both bacteria were isolated from six patients. Eradication of pathogen(s) was achieved in 7 of 12 patients (66%). Five patients (42%) died due to severe co-morbidity. Adverse events related to Q-D were not observed and neither renal nor liver function was adversely affected.

CONCLUSIONS:

Quinupristin-dalfopristin appears to be an efficient and safe antimicrobial drug for the rescue treatment of staphylococcal infections in critically ill patients. It may be considered as a treatment option in cases of vancomycin treatment failure.

PMID:
12185441
DOI:
10.1007/s00134-002-1358-7
[Indexed for MEDLINE]

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