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.