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Case Reports
. 2015 Sep-Oct;20(5):397-402.
doi: 10.5863/1551-6776-20.5.397.

Successful Daptomycin Use in a Pediatric Patient With Acute, Bilateral Osteomyelitis Caused by Methicillin-Resistant Staphylococcus aureus

Kelsey L Billups  1 , Jeremy S Stultz  2
Affiliations
Case Reports

Successful Daptomycin Use in a Pediatric Patient With Acute, Bilateral Osteomyelitis Caused by Methicillin-Resistant Staphylococcus aureus

Kelsey L Billups et al. J Pediatr Pharmacol Ther. 2015 Sep-Oct.

Abstract

Staphylococcus aureus is the most common bacteria associated with the development of osteomyelitis in pediatric patients. Osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA) can be difficult to safely and effectively treat. Vancomycin, linezolid, and clindamycin are commonly used to treat osteomyelitis caused by MRSA. While adult studies suggest intravenous (IV) daptomycin may by beneficial for the treatment of MRSA osteomyelitis, it is not Food and Drug Administration approved for use in pediatrics, and minimal data are available related to its use in this population. This case report describes the successful use of daptomycin (8 mg/kg/dose IV daily) combined with rifampin for 5 weeks, followed by 5 weeks of oral sulfamethoxazole/trimethoprim, for treatment of acute bilateral osteomyelitis caused by MRSA in an 8-year-old male. The patient did not initially respond to the combination of vancomycin plus rifampin and gentamicin, nor did he respond to ceftaroline treatment. After initiation of daptomycin, his fevers quickly subsided, his pain rapidly improved, and his inflammatory markers significantly decreased. While daptomycin was effective in this patient, additional research is needed to determine the true safety and efficacy of this drug for treatment of osteomyelitis caused by MRSA in pediatric patients.

Keywords: daptomycin; methicillin-resistant Staphylococcus aureus; osteomyelitis; pediatric.

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Figures

Figure 1.
Figure 1.
Temperature curve. C, ceftaroline; D, daptomycin; G, gentamicin; R, rifampin; V, vancomycin
Figure 2.
Figure 2.
C-reactive protein measurements. C, ceftaroline; D, daptomycin; G, gentamicin; R, rifampin; V, vancomycin
See this image and copyright information in PMC

References

    1. Peltola H, Paakkonen M, Kallio P, Kallio MJ. Osteomyelitis-septic arthritis study group. Short-versus long-term antimicrobial treatment for acute hematogenous osteomyelitis of childhood: prospective, randomized trial on 131 culture-positive cases. Pediatr Infect Dis J. 2010;29(12):1123–1128. - PubMed
    1. Hospira Inc. Vancomycin Hydrochloride Package Information. Lake Forest, IL: Hospira Inc; 2011.
    1. Pharmacia and Upjohn Co. Zyvox (Linezolid) Package Information. New York, NY: Pharmacia and Upjohn Co; 2013.
    1. Pharmacia and Upjohn Co. Cleocin Phosphate (Clindamycin Phosphate) Package Information. New York, NY: Pharmacia and Upjohn Co; 2011.
    1. Peltola H, Paakkonen M. Acute osteomyelitis in children. N Engl J Med. 2014;370(4):352–360. - PubMed

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