Successful combination therapy of teicoplanin with cefmetazole on postoperative cardiovascular MRSA infections: clinical report on two cases

摘要

We clinically evaluated the efficacy of the combination therapy of teicoplanin (TEIC) with cefmetazole (CMZ) in two patients, one (case 1) had developed surgical site infection and the other (case 2) mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA) after cardiovascular surgeries. TEIC (400 mg twice a day on day-1 and 400 mg once a day thereafter) was administered intravenously immediately after the end of drip infusion of CMZ (1.0 g twice a day). Both patients showed marked improvement on the 5th-day. The isolated MRSA from these two cases were subjected to the in vitro studies and synergistic effects between TEIC and CMZ were recognized under the checkerboard method. Thus, the favorable effects of the combination therapy might be attributable to the synergy between TEIC and CMZ recognized in vitro. These results suggest that the combination therapy of TEIC with CMZ may be useful in the treatment of severe MRSA infections.