What is the Role of Combination Therapy in Treating S. aureus Infections?
JUN 06, 2017 | CONTAGION® EDITORIAL STAFF
Prof. Josh Davis, MBBS, PhD, Principle Research Fellow, Menzies School of Health Research, Australia, discusses the role of combination therapy when it comes to treating invasive Staphylococcus aureus infections.
Interview Transcript (slightly modified for readability)
“The role of combination therapy in invasive Staphylococcus [aureus] infections is really not completely defined yet, though a lot of research has been done on [multiple] different combinations. At present, none of those combinations has been shown to be clinically superior to just standard monotherapy.
However, there is one promising set of combination therapies that we are working on further, and that’s combining beta-lactam antibiotics with standard therapy, and the standard therapy being either vancomycin or daptomycin.
So, for the other combination therapies apart from beta-lactam, they’ve all been shown either not to work or to cause more harm than good. An example is adding gentamicin to nafcillin—it does shorten the duration of bacteremia by about a day, but it doesn’t improve mortality and it causes more renal failure. So, that’s not recommended. Rifampicin, a recent trial has just been finished, called the ARREST trial, which [found] absolutely no benefit in adding rifampicin to standard therapy, and then there are several other agents, which also have not been shown to be of any benefit.
Beta-lactams, in vitro, in the laboratory, nearly all beta-lactams show synergy against MRSA, [methicillin-] resistant Staph aureus and [heterogenous vancomycin-intermediate Staphylococcus aureus] hVISA, when combined with either vancomycin or daptomycin, and there is some limited human data, but not enough yet to say that it’s superior to monotherapy. We’re currently running a large, randomized trial to try to answer that question.”
To stay informed on the latest in infectious disease news and developments, please sign upfor our weekly newsletter.
The new test can differentiate between Lyme disease and 7 other tick-borne diseases.
Contagion® is a fully integrated news resource covering all areas of infectious disease. Through our website, quarterly journal, email newsletters, social media outlets, and Outbreak Monitor we provide practitioners and specialists with disease-specific information designed to improve patient outcomes and assist with the identification, diagnosis, treatment, and prevention of infectious diseases. Our mission is to assure that the healthcare community and public have the knowledge to make more informed choices and have a positive impact on patient outcomes.
2 Clarke Drive
Cranbury, NJ 08512