aureus: repulsion of peptidoglycan-targeted antibodies.
ibitory and bactericidal titers to assess the adequacy of antibiotic therapy are often recommended for osteomyelitis and endocarditis (,). Peak and trough bactericidal titers of at least 1:64 and 1:32, respectively, were suggested as good predictors of a successful therapeutic outcome in patients with infective endocarditis (). However, the serum bactericidal titer (SBT) is subject to variation and lack of reproducibility with staphylococci (,). The serum test does not predict efficacy in animal models of endocarditis (,). Clinically, the test lacks precision in predicting outcome or bacteriological failure (, ,,). Clinical response and results of follow-up blood cultures remain the best indicators of clinical outcome. Re-analysis of data from two large multicenter studies showed that outcome was strongly correlated with trough titers of SBTs (, ). This supports the concept that the efficacy of beta-lactams depends on the time above the MIC, as most patients in these studies received beta-lactams as their principal therapy (). Currently, it is not possible to define the optimal trough titer for a successful outcome.
aureus infections are caused by MRSA strains.
aureus in simulated endocardial vegetations.
The definitive diagnosis of disease is made by isolation and identification of the species of Staphylococcus. Depending in the conditions being investigated, samples of sputum, purulent material, blood and urine should be obtained. Several sets of blood cultures are required to make a diagnosis of S. aureus septicemia or endocarditis. Echocardiography, especially transesophageal, is crucial for confirming the diagnosis of endocarditis.
aureus bacteremia/endocarditis trial [see Clinical Trials (14.2)].
equisimilis, and Enterococcus faecalis (vancomycin-susceptible isolates only).
Staphylococcus aureus Bloodstream Infections (Bacteremia), Including Those with Right-Sided Infective Endocarditis, Caused by Methicillin-Susceptible and Methicillin-Resistant Isolates
Limitations of Use
CUBICIN is not indicated for the treatment of left-sided infective endocarditis due to S.