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October 27, 1978

Staphylococcus aureus Endocarditis: Combined Therapy With Vancomycin and Rifampin

Author Affiliations

From the Departments of Pediatrics (Drs Faville, Kaplan, and Quie), Medicine (Drs Crossley and Sabath), and Microbiology (Dr Quie), and the Division of Clinical Pharmacy (Dr Zaske), University of Minnesota Hospitals, and the Departments of Pediatrics (Dr Faville) and Medicine (Dr Crossley), and the Division of Clinical Pharmacy (Dr Zaske), St Paul-Ramsey Hospital, St Paul.

JAMA. 1978;240(18):1963-1965. doi:10.1001/jama.1978.03290180037019

Two children with persistent bacteremia and endocarditis due to Staphylococcus aureus failed to respond to vancomycin therapy, even though serum levels greatly exceeded the inhibitory concentrations. The Staphylococcus from one patient was resistant to methicillin; the other patient had a penicillin hypersensitivity. There was a wide disparity between the minimum inhibitory and the minimum bactericidal concentrations of vancomycin. Striking clinical and laboratory evidence of improvement was demonstrated with the addition of rifampin therapy.

(JAMA 240:1963-1965, 1978)