Combination of ertapenem and penicillin M or cefazolin in the treatment of methicillin-susceptible Staphylococcus aureus bacteremia: multicenter case series - 01/05/26
, Yohan N’Guyen b, Pierre Danneels c, Guillaume Martin-Blondel d, Abdeljalil Zeggay e, Clément Viguier d, Kevin Bouiller aHighlights |
• | Anti-staphylococcal β-lactam combined with ertapenem is used in some hospitals for persistent MSSA bacteremia. |
• | Because blood culture results take time, 40% of patients received this dual therapy despite negative cultures. |
• | These antibiotic combinations may raise tolerability concerns and can induce severe encephalopathy. |
• | Although the effectiveness of this dual therapy appears promising, its indication remains to be defined. |
Abstract |
Background |
Dual therapy (DT) combining penicillin M or cefazolin with ertapenem has been proposed as treatment of complicated Staphylococcus aureus bacteremia (SAB). We aimed to outline the relevant clinical characteristics and outcomes in real-life practice .
Methods |
We conducted a multicenter retrospective study involving SAB cases treated with DT in five French university hospitals between January 2022 and December 2024.
Results |
Thirty-five patients were included, all of them presenting with complicated SAB. Although DT was prescribed for persistent bacteremia, only 21 patients (60%) had positive blood cultures at DT initiation, related to blood culture incubation time. Median bacteremia duration after DT was two days (IQR 1–3). Two serious adverse events (5.7%), both encephalopathy, were reported. Seven patients (20%) died, five related to SAB or its management.
Conclusions |
Due to blood culture delays, 40% of the patients had already cleared bacteremia before DT initiation. Further studies are needed to better define the role of this strategy and to identify the patients most likely to benefit.
Le texte complet de cet article est disponible en PDF.Keywords : Combination therapy, Ertapenem, Oxacillin, Cefazolin, Staphylococcus aureus
Plan
Vol 56 - N° 3
Article 105259- avril 2026 Retour au numéro
Article précédent
- Antibiotic tolerance and safety in infective endocarditis: A focus on older patients
- Capucine RICHARD, Sylvain GAUTIER, Pierre BOISSON DE CHAZOURNES, Karim JAFFAL, Ségolène PERRINEAU, Valérie SIVADON TARDY, Cyril CHARRON, Nicolas MANSENCAL, Aurélien DINH, Marion PÉPIN, on behalf of the endocarditis team of A. Paré Hospital
- HIV reservoir dynamics according to the timing of antiretroviral therapy initiation or modification
- Pierre Gantner, Christine Cheneau, Jakub Kowalczyk, Jean-Pierre Faller, Martin Martinot, Mahsa Mosheni-Zadeh, Anne Fuchs, David Rey, Samira Fafi-Kremer
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?