Daptomycin for the successful treatment of postoperative methicillin-resistant <i>Staphylococcus aureus</i> empyema: a case report

Yagi, Yusuke; Iizuka, Michiro; Okazaki, Moemi; Jobu, Kohei; Morita, Yasuyo; Miyamura, Mitsuhiko

doi:10.1080/1120009x.2021.1888029

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…However, a growing number of case reports have suggested that empyema can be refractory to vancomycin. 10,11 Our case report also found a concomitant pleural complication despite vancomycin treatment. Therefore, in the setting of ongoing MRSA pneumonia and empyema, one could consider using vancomycin to treat pneumonia and transition to daptomycin to treat empyema.…”

Section: Discussionsupporting

confidence: 58%

“…Daptomycin is a desirable option for treating empyema due to its potentially stronger penetration into the pleural space compared to vancomycin; this may improve the recovery rate and reduce the risk of complications such as a loculated pleural effusion as seen in our patient. 10 However, this finding stemmed from a case report within the setting of VRE empyema, which limits its generalizability. Additionally, daptomycin can be more conveniently dosed at once daily, while vancomycin requires more frequent dosing at twice daily and serial measurements of trough levels.…”

Section: Discussionmentioning

confidence: 94%

“…Furthermore, there have been 2 case reports suggesting that vancomycin may not be as effective as once originally thought; the reports demonstrated that daptomycin successfully treated MRSA empyema refractory to linezolid and vancomycin-resistant enterococci (VRE) empyema. 10,11 Although these reports are limited to a single patient, they suggest that daptomycin can treat MRSA empyema, particularly when unresponsive to standard antibiotics of choice including vancomycin and linezolid. As of yet, there has been no evidence-based comparison between daptomycin and vancomycin in the treatment of MRSA empyema.…”

Section: Introductionmentioning

confidence: 99%

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Successful Treatment With Daptomycin of MRSA Empyema Complicated by Right-Sided Loculated Pleural Effusion Refractory to Vancomycin

Torjani

Selbst

Hamsher

et al. 2022

Clin Med Insights Case Rep

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Empyema is a serious complication of pneumonia and has been reported to have a mortality rate of 8.7%. For methicillin-resistant Staphylococcus aureus (MRSA) empyema, treatment includes drainage and specific antibiotics such as vancomycin and linezolid. Strikingly, there are increasing incidences of empyema refractory to vancomycin and linezolid. Despite being inactivated in the lung parenchyma by pulmonary surfactant, daptomycin can penetrate the pleural space and may be better at treating MRSA empyema than vancomycin and linezolid. Some case reports have shown that daptomycin has been used to successfully treat MRSA empyema refractory to linezolid and vancomycin-resistant enterococcus (VRE) empyema. Here, we present a 26-year-old male with a past medical history of intravenous (IV) drug use, newly diagnosed HIV, HCV, and multifocal pneumonia complicated by a left-sided MRSA empyema that partially resolved with vancomycin and drainage. However, he subsequently developed a right-sided loculated pleural effusion. After the patient was switched to daptomycin with continued drainage, the right and left pleural effusions improved significantly. Once medically stable, he was discharged to a rehabilitation facility for further recovery. Our case report demonstrates that daptomycin could be considered as an effective treatment for MRSA empyema, particularly when refractory to vancomycin.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Successful Treatment With Daptomycin of MRSA Empyema Complicated by Right-Sided Loculated Pleural Effusion Refractory to Vancomycin

Torjani

Selbst

Hamsher

et al. 2022

Clin Med Insights Case Rep

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Is ceftriaxone a suitable option for the empirical treatment of postoperative pleural empyema?

Gözdaş

2021

Journal of Chemotherapy

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Empyema necessitans caused by methicillin-resistant Staphylococcus aureus: a case report and literature review

Nakamura,

Ishikawa,

Murata

et al. 2024

BMC Infect Dis

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Background Empyema necessitans (EN) is a rare condition characterized by pleural infection with pus spreading into adjacent soft tissues. Although Mycobacterium tuberculosis and Actinomyces israelii are common causative agents, methicillin-resistant Staphylococcus aureus (MRSA) is relatively rare, but it is associated with high mortality in empyema cases. We aimed to report a unique case of EN caused by MRSA and present a literature review to better understand this rare condition. Case presentation A 69-year-old man with a history of right ureteral stone presented with fever and left anterior thoracic pain. A physical examination revealed redness and swelling in the left thoracic region. Imaging studies confirmed EN with fluid accumulation around the sternocostal joint of the left first rib. MRSA was identified from blood and pleural fluid cultures. The patient received antimicrobial therapy, and a chest tube was inserted for drainage. Despite initial improvement, vertebral osteomyelitis was diagnosed on day 17. The antimicrobials were subsequently terminated after 6 weeks, but vertebral osteomyelitis recurred, and treatment was resumed and completed on day 215. Conclusion EN caused by MRSA is rare, and the literature review revealed 14 cases from human sources. Positive blood cultures were observed in 40% of cases, and metastatic infections were present in 30% of cases. Osteomyelitis was the most common type of metastatic lesion. All the patients underwent drainage. Patients with MRSA-associated EN frequently develop disseminated lesions and should therefore be carefully examined. Moreover, appropriate treatment with antibiotics and drainage is necessary for a good prognosis. Although the prognosis appeared to be favorable in our review, publication bias and treatment challenges for metastatic infections should be considered.

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Daptomycin for the successful treatment of postoperative methicillin-resistant Staphylococcus aureus empyema: a case report

Cited by 3 publications

References 16 publications

Successful Treatment With Daptomycin of MRSA Empyema Complicated by Right-Sided Loculated Pleural Effusion Refractory to Vancomycin

Successful Treatment With Daptomycin of MRSA Empyema Complicated by Right-Sided Loculated Pleural Effusion Refractory to Vancomycin

Is ceftriaxone a suitable option for the empirical treatment of postoperative pleural empyema?

Empyema necessitans caused by methicillin-resistant Staphylococcus aureus: a case report and literature review

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