Teicoplanin is a glycopeptide antibiotic that is highly effective against methicillin-resistant Staphylococcus aureus (MRSA).However,it is recommended that a loading procedure is used to enable teicoplanin to rapidly reach optimal plasma trough levels.Fosfomycin,a cell wall synthesis-inhibiting antibiotic,prevents biofilm formation through the inhibition of penicillin-binding protein 2’in MRSA.
We report a case in which teicoplanin and fosfomycin had a marked synergistic effect in a patient with a serious MRSA infection,in whom C-reactive protein levels stayed high despite teicoplanin having reached an optimal plasma concentration.The combination of fosfomycin and teicoplaninachievedobviousimprovementsininflammatorymarkersandMRSAwas eradicated from the blood and sputum.
