PMID- 18349306
OWN - NLM
STAT- MEDLINE
DCOM- 20080630
LR  - 20131121
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 42
IP  - 5
DP  - 2008 May
TI  - Successful treatment of vancomycin-resistant Enterococcus faecium pyelonephritis 
      with daptomycin during pregnancy.
PG  - 722-5
LID - 10.1345/aph.1K561 [doi]
AB  - OBJECTIVE: To report successful treatment using daptomycin for pyelonephritis 
      associated with vancomycin-resistant Enterococcus faecium (VRE) in a 27-week 
      pregnant woman. CASE SUMMARY: A 20-year-old 27-week pregnant patient with a 
      history of spina bifida, neurogenic bladder, and multiple hospitalizations for 
      recurrent urinary tract infections (UTIs) was diagnosed with pyelonephritis. She 
      was treated with daptomycin 260 mg (4 mg/kg) daily for 14 days on the basis of a 
      urine culture that revealed E. faecium resistant to ampicillin, nitrofurantoin, 
      and vancomycin. All cultures following treatment revealed no growth, and the 
      patient as well as the neonate displayed no adverse effects. DISCUSSION: VRE UTIs 
      can be treated safely in pregnancy with nitrofurantoin, if the organism is 
      susceptible. Other viable options in the treatment of VRE, including linezolid, 
      doxycycline, and quinupristin/dalfopristin, have lower urinary concentrations, 
      teratogenic risk, or limited findings regarding their safety in pregnancy. 
      Daptomycin was selected in this case due to its efficacy in the treatment of VRE, 
      high urinary concentrations, pregnancy category B, and one case report indicating 
      its successful use in pregnancy. CONCLUSIONS: Treatment of VRE in pregnancy can 
      be challenging due to the teratogenicity or unknown safety of available options. 
      The use of daptomycin in our patient enabled a successful outcome of 
      multidrug-resistant E. faecium in a complicated pregnant patient without observed 
      neonatal abnormalities.
FAU - Shea, Katherine
AU  - Shea K
AD  - Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, VA, USA. 
      kshea@clarian.org
FAU - Hilburger, Esther
AU  - Hilburger E
FAU - Baroco, Allison
AU  - Baroco A
FAU - Oldfield, Edward
AU  - Oldfield E
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20080318
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - NWQ5N31VKK (Daptomycin)
SB  - IM
MH  - Adult
MH  - Daptomycin/pharmacology/*therapeutic use
MH  - Enterococcus faecium/drug effects/*isolation & purification
MH  - Female
MH  - Gram-Positive Bacterial Infections/*drug therapy/microbiology
MH  - Humans
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*drug therapy/microbiology
MH  - Pyelonephritis/*drug therapy/microbiology
MH  - Treatment Outcome
MH  - Vancomycin Resistance/*drug effects/physiology
EDAT- 2008/03/20 09:00
MHDA- 2008/07/01 09:00
CRDT- 2008/03/20 09:00
PHST- 2008/03/20 09:00 [pubmed]
PHST- 2008/07/01 09:00 [medline]
PHST- 2008/03/20 09:00 [entrez]
AID - aph.1K561 [pii]
AID - 10.1345/aph.1K561 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2008 May;42(5):722-5. doi: 10.1345/aph.1K561. Epub 2008 Mar 18.