Pharmacotherapeutic options for treating Staphylococcus aureus bacteremia

Abstract

Case-fatality rates for Staphylococcus aureus bacteremia (SAB) remain unacceptably high and have improved only modestly in recent decades. Treatment of SAB is still a clinical challenge, especially if methicillin-resistant strains are involved. New drugs with anti-staphylococcal activity are currently available, and their role as alternatives to standard therapies is being investigated. Areas covered: In this review, we give an update of the current available antibiotics for the treatment of SAB. We provide information regarding the pharmacological characteristics, the accepted indications, and the most important adverse events of the old and new anti-staphylococcal agents, as well as the existing evidence on their use for the treatment of SAB. Expert opinion: The management of patients with SAB is very complex and needs a multidisciplinary approach. There are currently new available options for the treatment of methicillin-resistant SAB. However, more data from clinical trials are needed to assign specific roles to each antibiotic and to include them in the new antibacterial armamentarium. The role of combination therapy for the treatment of increasingly complex patients with SAB deserves thorough investigation.

Keywords: Bacteraemia; bloodstream infection; ceftaroline; ceftobiprole; cephazolin; clindamycin; cotrimoxazole; dalvabancin; daptomycin; fosfomycin; linezolid; methicillin-resistant Staphylococcus aureus; methicillin-susceptible Staphylococcus aureus; oritavancin; tedizolid; teicoplanin; telavancin; tigecycline; vancomycin.