Combination therapy with polymyxin B-immobilized fibre haemoperfusion and teicoplanin for sepsis due to methicillin-resistant Staphylococcus aureus.

Abstract

The aim of the present study was to determine whether treatment with polymyxin B-immobilized fibre (PMX-F) haemoperfusion, teicoplanin, or both in combination is effective in patients with methicillin-resistant Staphylococcus aureus (MRSA) sepsis. Sixty patients with MRSA sepsis were randomly assigned to one of four treatments: (A) PMX-F treatment (N=15), (B) teicoplanin treatment (N=15), (C) PMX-F and teicoplanin in combination (N=20) and (D) conventional therapy (N=10). PMX-F treatment was repeated twice. Teicoplanin was administered by intravenous injection. Plasma endotoxin levels were determined by endospecy test. Plasma endotoxin levels were reduced in groups A and C (P<0.05). Survival rates were 53, 47, 90, and 20% in groups A, B, C and D, respectively (group C versus group A, P<0.05; group C versus group B, P<0.01; group C versus group D,P <0.001). The mean duration of stay was 44, 42, 28 and 56 days in groups A, B, C and D, respectively. Our data suggest that combination therapy with PMX-F and teicoplanin is effective for sepsis caused by MRSA.

• Authors: T Nakamura, C Ushiyama, Y Suzuki, T Inoue, H Shoji, N Shimada, H Koide
• Journal: The Journal of hospital infection (J Hosp Infect) Vol. 53 Issue 1 Pg. 58-63 (Jan 2003) ISSN: 0195-6701 [Print] England
• PMID: 12495686 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Endotoxins
• Teicoplanin
• Polymyxin B

Topics

• Anti-Bacterial Agents (therapeutic use)
• Combined Modality Therapy
• Double-Blind Method
• Endotoxins (antagonists & inhibitors, blood)
• Female
• Hemoperfusion (methods)
• Humans
• Male
• Methicillin Resistance
• Middle Aged
• Polymyxin B (therapeutic use)
• Sepsis (therapy)
• Staphylococcal Infections (therapy)
• Staphylococcus aureus
• Teicoplanin (therapeutic use)
• Treatment Outcome