Vancomycin-Resistant Enterococcus Faecium Prosthetic Valve Endocarditis Treated with Daptomycin and Ampicillin Combination.

BACKGROUND

Vancomycin resistant Enterococcus faecium (VRE) bacteremia and infective endocarditis (IE) are difficult to treat and associated with high mortality.

METHODS

We describe a case of a 78-year-old male with VRE prosthetic valve endocarditis treated with combined daptomycin/ampicillin. We review published literature on the treatment of VRE IE and summarize other published case reports of daptomycin combination therapy.

RESULTS

Prompt clearance of bacteremia was achieved. Cardiac valve replacement surgery was pursued but was followed by post-operative complications and ultimately the patient did not survive.

CONCLUSION

There is limited published literature on the treatment of VRE IE and an optimal antibiotic regimen has not been established. This case adds to the growing body of literature demonstrating the use of daptomycin and beta-lactam combination therapy for VRE bacteremia and endocarditis. Combination therapy may be an appropriate choice for select cases; however, reports of treatment failure warrant caution.