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Combined Therapy With Vancomycin and Rifampin

Ralph J. Faville, Jr, MD; Darwin E. Zaske, PharmD; Edward L. Kaplan, MD; Kent Crossley, MD; L. D. Sabath, MD; Paul G. Quie, MD

JAMA. 1978;240(18):1963-1965.

Abstract
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)

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.

Footnotes
Read in part before the 16th Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Oct 28, 1976.

Reprint requests to Department of Pediatrics, St Paul-Ramsey Hospital, 640 Jackson St, St Paul, MN 55101 (Dr Faville).

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