New therapeutic approach for the treatment for staphylococcal bacteremia and sepsis

Introduction. Staphylococcal bacteremia is an early and dangerous manifestation of infection, it indicates to the presence of the source of infection in the bloodstream or the dissemination ofgerms from otherfoci, is the cause of high mortality rate. In that the approaches to the treatment for bacteremia/sepsis caused by S.aureus, have surprisingly low conclusiveness and require the optimization of antibiotic therapy, duration of treatment, criteria for cure. The aim of this study was to perform the systematic analysis of the current literature devoted to the problem of antibiotic treatment for staphylococcal infection, primarily followed by bacteremia and sepsis. Objectives of the study: the detection of the problem factors having the negative impact on the effectiveness of the antibiotic treatment of severe staphylococcal infections followed by bacteremia, and prospects for the use of new antibiotics. For the solution of the designated objectives in the scientific medical databases Medscape and Pubmed there was performed the search for the publications on subject headings, covering these problems Conclusion. Bacteremia and sepsis caused by S.aureus is not uncommon and severe infection which occurs everywhere, but remains to be poorly understood. The single isolation of S.aureus from the blood always is to be considered as clinically significant due to the high pathogenicity, high probability of infection and complications, rarity of contamination of blood samples with S.aureus. In cases of the isolation of staphylococci from the blood there is required an immediate and thorough search for any focus of invasion and deep metastatic foci of infection. There are strong evidences that the removal of the origin or the drainage of the locus of infection improves the results of the treatment. There is substantially less certainty about the patients with uncomplicated infections that can receive short courses of ABT. There is discussed the optimal choice of antibiotics, the duration and method of administration for the treatment of S. aureus bacteremia (SAB). Available data indicate to the more higher efficiency of f-lactams compared with glycopeptides for the treatment for infections caused by methicillin-sensitive SAB, the emergence of glycopeptide-intermediate Staphylococcus aureus (GISA) or hetero-GISA reduces the role of glycopeptides in the treatment of bacteremia caused by MRSA. Daptomycin showed the high efficacy in the treatment for severe staphylococcal infections accompanied by bacteremia and sepsis, especially when using in a dose of 6 mg/kg/ day and above. There is insufficient data for the assertion that cephalosporins are also effective as penicillins for treating SAB, but they are probably more effective than vancomycin for the treatment of methicillinsensitive SAB. The optimal duration of treatment is considered to be 10-14 days of intravenous administration for most cases of uncomplicated SAB associated with vascular catheterization, upon condition of the removal of the catheter and low risk of endocarditis.

S.aureus, bacteremia, sepsis, antibiotics, linezolid, daptomycin