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Successful Use of Intrathecal Daptomycin to Treat Meningitis Due to Vancomycin-Resistant Enterococcus faecium

Kahler, Ralph C. MD*; Holloway, Katherine PharmD, BCPS

Infectious Diseases in Clinical Practice: November 2012 - Volume 20 - Issue 6 - p 416–418
doi: 10.1097/IPC.0b013e3182506d8f
Case Reports

Central nervous system infections are frequently associated with cerebrospinal fluid shunting procedures. Although most infections associated with central nervous system shunting procedures are caused by staphylococci, enterococci, including vancomycin-resistant enterococci, are increasingly a cause of nosocomial and community-acquired infections. We report a case in which a combination of intravenous and intrathecal daptomycin successfully eradicated vancomycin-resistant Enterococcus faecium infection of a cerebrospinal fluid shunt in a 59-year-old woman. In our patient, intrathecal daptomycin at a dose of 5 mg every 3 days resulted in microbiologic improvement 6 days after the initiation of therapy without a clinically significant rise in creatine phosphokinase levels.

From the *Hattiesburg Clinic, Hattiesburg, MS and †Cubist Pharmaceuticals, Inc, Lexington, MA.

Correspondence to: Ralph C. Kahler, MD, Hattiesburg Clinic, 415 S 28th Ave, Hattiesburg, MS 39401. E-mail:

Disclosures of Potential Conflicts of Interest: Dr. Kahler is a member of the Cubist Pharmaceuticals, Inc. Speakers Bureau. Dr. Holloway is an employee and stockholder of Cubist Pharmaceuticals, Inc.

Cubist Pharmaceuticals, Inc. provided funding for manuscript preparation but did not provide any other funding.

© 2012 Lippincott Williams & Wilkins, Inc.