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15 June 2007

Volume 44, Number 12
Clinical Infectious Diseases 2007;44:1543–1548
1058-4838/2007/4412-0004$15.00
DOI: 10.1086/518452
IDSA LECTURE

Counterpoint: Vancomycin and Staphylococcus aureus—An Antibiotic Enters Obsolescence

Stan Deresinski

Division of Infectious Disease and Geographic Medicine, Department of Medicine, Stanford University, Stanford, and Division of Infectious Disease, Santa Clara Valley Medical Center, San Jose, California

The efficacy of vancomycin for the treatment of patients with infections due to Staphylococcus aureus is impaired by its poor tissue penetration and by its relatively weak antibacterial activity—an activity that is declining as S. aureus evolves. Neither dose escalation nor use of vancomycin in combination with other antibiotics that have antistaphylcoccal activity has been demonstrated to safely enhance its therapeutic efficacy. Although no clinical trials suggest superiority of vancomycin over any comparator, some have provided evidence of its inferiority. Strong consideration should be given to the use of alternative agents in the treatment of serious S. aureus infections.

Received 8 January 2007; accepted 24 March 2007; electronically published 4 May 2007.

Reprints or correspondence: Dr. Stan Deresinski, 2900 Whipple Ave., Ste. 115, Redwood City, CA 94062 ().

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  • This is a modified version of a paper presented at the 44th Annual Meeting of the Infectious Diseases Society of America, Toronto, Ontario, Canada, 12–15 October 2006 (session 12L).

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