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. 2020 Dec 16;65(1):e01746-20.
doi: 10.1128/AAC.01746-20. Print 2020 Dec 16.

Imipenem plus Fosfomycin as Salvage Therapy for Vertebral Osteomyelitis

Itaru Nakamura  1 , Tetsuo Yamaguchi  2 , Kotaro Aoki  3 , Yuri Miura  1 , Satoko Sato  1 , Hiroaki Fujita  1 , Hidehiro Watanabe  1
Affiliations

Imipenem plus Fosfomycin as Salvage Therapy for Vertebral Osteomyelitis

Itaru Nakamura et al. Antimicrob Agents Chemother. .

Abstract

We applied combination antibiotic therapy to treat vertebral osteomyelitis and a psoas abscess caused by glycopeptide-intermediate (MIC, 2 μg/ml) and daptomycin-nonsusceptible (>2 μg/ml) methicillin-resistant Staphylococcus aureus The Etest synergy test showed the largest synergistic effects for imipenem/cilastatin and fosfomycin. Whole-gene sequencing showed amino acid changes in SA0802, SA1193 (mprF), and SA1531 (ald). Four weeks of combination treatment using imipenem/cilastatin (1.5 g per day) and fosfomycin (4.0 g per day) resulted in clinical improvement.

Keywords: Etest synergy test; antibiotic combination; fosfomycin; imipenem; whole genome analysis.

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