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Successful Treatment of Corynebacterium striatum Endocarditis with Daptomycin plus Rifampin

¹ Clinical Pharmacist, Department of Pharmaceutical Services, Newark Beth Israel Medical Center, Newark, NJ
² Medical Director, Infection Control and Epidemiology, Division of Infectious Diseases, Newark Beth Israel Medical Center

Reprints: Dr. Shah, Department of Pharmaceutical Services, Newark Beth Israel Medical Center, 201 Lyons Ave., Newark, NJ 07112-2027, fax 973/926-2751, moshah{at}sbhcs.com

OBJECTIVE: To report a case of Corynebacterium striatum endocarditis that was treated successfully with daptomycin plus rifampin following an unsuccessful attempt at vancomycin desensitization and failure of linezolid therapy.

CASE SUMMARY: A 46-year-old woman with hemodialysis-dependent chronic renal failure was admitted for a graft-related infection. She presented with C. striatum endocarditis that was treated with daptomycin plus rifampin due to a history of allergies to vancomycin and ß-lactam antibiotics and failure of linezolid therapy. The patient received daptomycin and rifampin for a total of 6 weeks. Three months after completion of treatment, no recurrence of endocarditis was evident.

DISCUSSION: Daptomycin is a lipopeptide antibiotic, with rapid bactericidal activity. It has demonstrated efficacy in animal models of staphylococcal, streptococcal, and enterococcal endocarditis. Case reports of its activity in methicillin-resistant Staphylococcus aureus endocarditis have also been documented.

CONCLUSIONS: Daptomycin, which has shown in vitro activity against C. striatum, may be a viable treatment option for patients with C. striatum endocarditis who are either allergic or refractory to traditional antibiotics.

Key Words: Corynebacterium striatum endocarditis, daptomycin, rifampin

Published Online, September 6, 2005. www.theannals.com, DOI 10.1345/aph.1G242

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