Vancomycin is the drug of choice in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection. However, the presence of certain clinical complications like renal failure alters vancomycin pharmacokinetics, leading to drug accumulation and toxicity. This highlights the need to identify an effective substitute for treating MRSA infections when vancomycin cannot be used. We report the case of a 57-y-old Indian male diagnosed with tricuspid valve endocarditis with septicaemia and a right upper lobe cavity caused by MRSA. The patient also presented with renal failure, which precluded the use of vancomycin for treatment. A 6-week regimen of teicoplanin and rifampicin was used instead, and the infection was successfully treated. This case report provides evidence of the effectiveness of teicoplanin and rifampicin in the treatment of MRSA bacteraemia in situations where the use of vancomycin is contraindicated.

作者：Kavitha, Saravu；Chiranjay, Mukhopadhyay；Vishwanath, Satyanarayanan；Ananth, Pai；Ashok Sebastian, Komaranchath；Frenil, Munim；Barkur Ananthakrishna, Shastry；Devasia, Tom

来源：Scandinavian journal of infectious diseases 2012 年 44卷 7期