Dirençli Gram Pozitif İnfeksiyon Tedavisinde Vankomisin ve Linezolid Kombinasyonu: Vaka Sunumu

Öz

Linezolid ve vankomisin çok ilaca dirençli Gram pozitif bak- terilerin neden olduğu infeksiyonların tedavisinde günümüz- de başarıyla kullanılmaktadır. Etki spektrumlarının benzerli- ği nedeniyle klasik olarak birlikte kullanılmazlar. Bu maka- lede, ventilatör ilişkili pnömoni ve kateter ilişkili kan akımı infeksiyonu nedeniyle; vankomisin ve linezolid tedavilerinin beraber kullanıldığı ve tedaviye olumlu yanıt alınan bir has- tayı sunduk. Edindiğimiz tecrübe, linezolid tedavisi almakta olan hastada dirençli Gram pozitif bakteriler ile bakteriosta- tik tedavi verilemeyecek kadar ciddi yeni bir infeksiyon geliştiğinde, linezolid ve vankomisin tedavilerini beraber kullanabileceğimiz kanısı oluşturdu

Anahtar Kelimeler

• Linezolid,vankomisin,pnömoni

Vancomycin and Linezolid Combination for the Treatment of Resistant Gram-Positive Infection: Case Report

Öz

Linezolid and vancomycin have been used successfully in the treatment of infections caused by multidrug resistant gram-positive bacteria. Due to the similarity of the anti- bacterial spectrum, they are not classically used in combi- nation. Herein we present a patient who was successfully treated for catheter-related bloodstream infection and ventilator-associated pneumonia with linezolid and van- comycin combination. Our experience was that; linezolid and vancomycin combination can be used when either patient has a resistant Gram-positive bacterial infection or has a new onset severe infection that can not be treated with bacteriostatic agents

Anahtar Kelimeler

• Linezolid,vancomycin,pneumonia

Kaynakça

1. Donowitz GR, Cox HL. Linezolid and other oxazolidi- nones. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Dougllas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed. Philadelphia: Churchill Livingstone Elsevier, 2010: 471-4.
2. https://doi.org/10.1016/B978-0-443-06839-3.00033-3
3. Jacqueline C, Caillon J, Le Mabecque V, Miegeville AF, Donnio PY, Bugnon D, et al. In vitro activity of linezolid alone and in combination with gentamicin, vancomycin or rifampicin against methicillin-resistant Staphylococcus aureus by time-killcurve methods. J Antimicrob Chemother. 2003 Apr; 51:857-64.
4. https://doi.org/10.1093/jac/dkg160
5. Georges H, Leroy O, Alfandari S, Guery B, Roussel- Delvallez M, Dhennain C, et al. Pulmonary disposition of vancomycin in critically ill patients. Eur J Clin Microbiol Infect Dis. 1997;16:385-8.
6. https://doi.org/10.1007/BF01726369
7. Lamer C, de Beco V, Soler P, Calvat S, Fagon JY, Dombret MC, et al. Analysis of vancomycin entry into pulmonary lining fluid by bronkoalveolar lavage in critically ill patients. Antimicrob Agents Chemother 1993;37:281-6.
8. https://doi.org/10.1128/AAC.37.2.281

9. Kohno S, Yamaguchi K, Aikawa N, Sumiyama Y, Odagiri S, Aoki N, et al. Linezolid versus vancomycin for treatment of infections caused by meticillin- resis- tant Staphylococcus aures in Japan. J Antimicrob Chemother 2007;60:1361-9.
10. https://doi.org/10.1093/jac/dkm369
11. Wunderik RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, et al. Linezolid in methicilin- resistant Staphylococcus aureus nosocomial pneumo- nia: a randomized, controlled study. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 2012;54:621-9.
12. https://doi.org/10.1093/cid/cir895
13. Reveles KR, Mortensen EM, Attridge RT, Frei CR. Comparative-effectiveness of vancomycin and linezo- lid as part of guideline-recommended empiric therapy for healthcare-associated pneumonia. BMC Res Notes. 2015;8:450.
14. https://doi.org/10.1186/s13104-015-1396-1
15. Takada H, Hifumi T, Nishimoto N, Kanemura T,Okada I, Kiriu N, et al. Linezolid versus vancomycin for noso- comial pneumonia due to methicillin-resistant Staphylococcus aueus in the elderly: A retrospective cohort analysis: Effectiveness of linezolid in the elderly. Am J Emerg Med. 2017;35:245-8.
16. https://doi.org/10.1016/j.ajem.2016.10.058
17. Ribes S, Pachon-Ibanez ME, Dominquez MA, Fernandez R, Tubau F, Ariza J, et al. In vitro and in vivo activities of linezolid alone and combined with vancomycin and imipenem against Staphylococcus aureus with reduced susceptibility to glycopeptides. Eur J Clin Microbiol Infect Dis 2010;29:1361-7.
18. https://doi.org/10.1007/s10096-010-1007-y
19. Davis JS, Van Hal S,Tong SY. Combination antibiotic treatment of serious methicillin-resistantStaphylococcus aureus infections. Semin Respir Crit Care Med. 2015;36:3-16.
20. https://doi.org/10.1055/s-0034-1396906