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Combination Antimicrobial Therapy for Gram (+) Bacteremia
- Bacteremia is a major cause of morbidity and mortality in the critically ill patient.
- S.aureus remains a common isolate in patients with either hospital-acquired or community-acquired bacteremia.
- In cases of suspected endocarditis due to S.aureus, traditional teaching has been to give an aminoglycoside (i.e. gentamicin) in combination with vancomycin or an antistaphylococcal penicillin.
- Importantly, there is no strong evidence to support this combination in patients with suspected S.aureus bacteremia.
- Furthermore, patients receiving the aminoglycoside combination have higher rates of renal impairment without any added clinical benefit.
References
Abad CL, Kumar A, Safdar N. Antimicrobial therapy of sepsis and septic shock - When are two drugs better than one? Crit Care Clin 2011;27:e1-e27.