Advertisement
Letter to the Editor| Volume 365, ISSUE 3, P318-320, March 2023

Vancomycin-clindamycin combination therapy for the treatment of gram-positive infections, in-vitro antagonism vs. clinical benefits

  • Zahra Sahraei
    Affiliations
    Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Search for articles by this author
  • Shervin shokouhi
    Affiliations
    Department of Infectious Disease and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Search for articles by this author
  • Shahab MeskiniMood
    Affiliations
    Department of Pharmacology & Toxicology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
    Search for articles by this author
  • Saghar Barati
    Correspondence
    Corresponding author at: Department of Clinical pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Rafsanjani Highway, Valiasr ave, Tehran 6153-14155, Iran.
    Affiliations
    Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Search for articles by this author
      Bacterial infections caused by gram-positive strains remain one of the major causes of admission to intensive care units. Pathogens such as Staphylococcus aureus, Enterococci, and Streptococcus pneumonia have had significant roles in increasing the mortality and morbidity of diseases ranging from minor skin infections to bacteremia, endocarditis, necrotizing pneumonia, and toxic shock syndrome (TSS).
      • Woodford N
      • Livermore DM.
      Infections caused by Gram-positive bacteria: a review of the global challenge.
      ,
      • Zhu Q
      • Yue Y
      • Zhu L
      • et al.
      Epidemiology and microbiology of gram-positive bloodstream infections in a tertiary-care hospital in Beijing, China: a 6-year retrospective study.
      Along with the development of antibiotics, drug resistance by the next generations of bacteria has created new challenges. Therefore, prescribing the appropriate antibacterial regimen is crucial, as the use of each antibiotic affects the bacterial ecology and the corresponding resistance to it. The emergence of multi-drug-resistant germs threatens practitioners’ ability to treat health problems and increases the cost of health care.
      • Woodford N
      • Livermore DM.
      Infections caused by Gram-positive bacteria: a review of the global challenge.
      ,
      • Norrby R
      • Powell M
      • Aronsson B
      • et al.
      The bacterial challenge: time to react.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Woodford N
        • Livermore DM.
        Infections caused by Gram-positive bacteria: a review of the global challenge.
        J Infect. 2009; 59: S4-S16
        • Zhu Q
        • Yue Y
        • Zhu L
        • et al.
        Epidemiology and microbiology of gram-positive bloodstream infections in a tertiary-care hospital in Beijing, China: a 6-year retrospective study.
        Antimicrob Resist Infect Control. 2018; 7: 107
        • Norrby R
        • Powell M
        • Aronsson B
        • et al.
        The bacterial challenge: time to react.
        Eur Cent Dis Prev Control. 2009;
        • General principles of antimicrobial therapy
        Mayo Clinic Proceedings.
        Elsevier, 2011
        • McConeghy KW
        • Bleasdale SC
        • Rodvold KA.
        The empirical combination of vancomycin and a β-lactam for staphylococcal bacteremia.
        Clin Infect Dis. 2013; 57: 1760-1765
        • Moran GJ
        • Krishnadasan A
        • Gorwitz RJ
        • et al.
        Methicillin-resistant S. aureus infections among patients in the emergency department.
        New Engl J Med. 2006; 355: 666-674
        • Klevens RM
        • Edwards JR
        • Tenover FC
        • et al.
        Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992–2003.
        Clin Infect Dis. 2006; 42: 389-391
        • America IDSo
        The 10×’20 Initiative: pursuing a global commitment to develop 10 new antibacterial drugs by 2020.
        Clin Infect Dis. 2010; 50: 1081-1083
        • Clay AS
        • Behnia M.
        A 55-year-old man with fever, renal failure, and hip pain.
        Chest. 2001; 119: 281-284
        • Stevens DL
        • Gibbons AE
        • Bergstrom R
        • et al.
        The Eagle effect revisited: efficacy of clindamycin, erythromycin, and penicillin in the treatment of streptococcal myositis.
        J Infect Dis. 1988; 158: 23-28
        • Elipoulos G.
        Antimicrobial combinations.
        Antibiot Lab Med. 1991; : 432-492
        • Booker BM
        • Stahl L
        • Smith PF.
        In vitro antagonism with the combination of vancomycin and clindamycin against Staphylococcus aureus.
        J Appl Res Clin Exp Therap. 2004; 4: 385-395
        • Hodille E
        • Badiou C
        • Bouveyron C
        • et al.
        Clindamycin suppresses virulence expression in inducible clindamycin-resistant Staphylococcus aureus strains.
        Ann Clin Microbiol Antimicrob. 2018; 17: 1-6
        • Venditti M
        • Baiocchi P
        • Santini C
        • et al.
        Potential of clindamycin in addition to vancomycin for the treatment of oxacillin-resistant Staphylococcus aureus septicemia persisting under vancomycin therapy.
        Int J Antimicrob Agents. 1995; 5: 123-128
        • Wargo KA
        • McCreary EK
        • English TM.
        Vancomycin combined with clindamycin for the treatment of acute bacterial skin and skin-structure infections.
        Clin Infect Dis. 2015; 61: 1148-1154
        • Ho JL
        • Klempner MS.
        In vitro evaluation of clindamycin in combination with oxacillin, rifampin, or vancomycin againstStaphylococcus aureus.
        Diagn Microbiol Infect Dis. 1986; 4: 133-138
        • White RL.
        What in vitro models of infection can and cannot do.
        Pharmacotherapy. 2001; 21: 292S-301S