Prosthetic Valve Endocarditis Caused by Staphylococcus epidermidis: Development of Rifampin Resistance During Vancomycin and Rifampin Therapy

Bruce Chamovitz, Richard E. Bryant, David N. Gilbert, Alan I. Hartstein

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Abstract

Development of rifampin-resistant Staphylococcus epidermidis was documented in three patients receiving vancomycin and rifampin therapy for prosthetic valve endocarditis. The minimum inhibitory concentrations and minimum bactericidal concentrations of rifampin for the original three isolates were 0.4 μg/mL or less. Organisms cultured during relapse or prosthetic valve replacement had minimum inhibitory concentrations of rifampin that were 12.5, 50, and greater than 100 μg/mL, respectively. Surgical intervention was necessary in all patients. One died, and one required a second prosthetic valve placement. The patients were treated with vancomycin plus aminoglycoside following identification of rifampin resistance. These observations suggest that vancomycin and rifampin may not be adequate therapy for prosthetic valve endocarditis caused by S epidermidis.

Original languageEnglish (US)
Pages (from-to)2867-2868
Number of pages2
JournalJAMA: The Journal of the American Medical Association
Volume253
Issue number19
DOIs
StatePublished - May 17 1985

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ASJC Scopus subject areas

  • Medicine(all)

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