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A Febrile Neutropenic Patient with Enterococcus gallinarum Sepsis Treated with Daptomycin and Gentamicin
Author(s) -
Barber Gerard R.,
Lauretta Joseph,
Saez Ruben
Publication year - 2007
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.27.6.927
Subject(s) - daptomycin , gentamicin , bacteremia , medicine , enterococcus , antimicrobial , sepsis , microbiology and biotechnology , vancomycin resistant enterococcus , intensive care medicine , antibiotics , staphylococcus aureus , biology , vancomycin , bacteria , genetics
Gram‐positive pathogens are increasingly implicated in today's changing epidemiology of hospital‐acquired infections. Staphylococci, streptococci, and enterococci are among the most frequently identified causes of surgical site, complicated skin‐structure, and bloodstream infections. In accordance, the use of antimicrobial agents with gram‐positive activity, especially those with activity against resistant organisms, has also increased. We describe a septic, neutropenic patient with bacteremia due to Enterococcus gallinarum . Therapeutic options were restricted due to resistance factors of the organism, limited guidance in the medical literature, and the patient's history and underlying condition. Despite these challenges, the patient was successfully treated with a combination of daptomycin and gentamicin and replacement of her indwelling central line. As antimicrobial stewards and diagnosticians, we must bear in mind that selective pressures exerted by the increasing use of agents with gram‐positive activity may result in an increased prevalence of organisms such as E. gallinarum .