A successful treatment of an infective endocarditis caused by methicillin-resistant Staphylococcus aureus with a combination of cefmetazole with fosfomycin

Keiichi Fukuda, K. Yoshio, S. Handa, T. Yoshikawa, H. Uchida, Y. Nakamura

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

A case of infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA) was successfully treated with a combination therapy with cefmetazole (CMZ) and fosfomycin (FOM). A 55 year old man was admitted to the Keio Hospital because of fever of unknown origin. Physical examination revealed blood pressure of 132/62 mmHg, heart rate of 118/min and body temperature of 39.8°C. Diastolic regurgitant murmur (Levine II/VI) was heard at the left sternal border on the third intercostal space. Chest X-ray showed mild cardiomegaly. Two dimensional echocardiography and color flow mapping demonstrated mildly dilated and hyperkinetic left ventricle, redundant aortic valve, giant vegetation from the aortic valve and severe aortic regurgitation. MRSA was isolated from the blood of this patient. Bacteriostatic synergism between CMZ and FOM against S. aureus isolated from the blood of this patient was detected both by the Kirby-Bauer method and by the checker-board method. The combination therapy with CMZ and FOM cleared the clinical symptoms and normalized the inflammatory reactions. No relapse was observed for at least 10 months. We concluded that the combination therapy with CMZ and FOM was invaluable for the treatment of infectious endocarditis by MRSA.

Original languageEnglish
Pages (from-to)1913-1918
Number of pages6
JournalJapanese Journal of Antibiotics
Volume42
Issue number9
Publication statusPublished - 1989

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Cefmetazole
Fosfomycin
Methicillin-Resistant Staphylococcus aureus
Endocarditis
Aortic Valve
Fever of Unknown Origin
Heart Murmurs
Aortic Valve Insufficiency
Cardiomegaly
Therapeutics
Body Temperature
Physical Examination
Heart Ventricles
Echocardiography
Staphylococcus aureus
Thorax
Color
Heart Rate
X-Rays
Blood Pressure

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology

Cite this

A successful treatment of an infective endocarditis caused by methicillin-resistant Staphylococcus aureus with a combination of cefmetazole with fosfomycin. / Fukuda, Keiichi; Yoshio, K.; Handa, S.; Yoshikawa, T.; Uchida, H.; Nakamura, Y.

In: Japanese Journal of Antibiotics, Vol. 42, No. 9, 1989, p. 1913-1918.

Research output: Contribution to journalArticle

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