vancomycin + beta-lactam

The combination antibiotic regimen consisting of a glycopeptide (typically vancomycin) or a lipopeptide (daptomycin) plus a beta-lactam antibiotic (such as flucloxacillin, cloxacillin, or cefazolin) was evaluated in the CAMERA 2 (Combination Antibiotic Therapy for Methicillin Resistant Staphylococcus Aureus Infection) clinical trial. Led by the Menzies School of Health Research, this Phase 3 trial investigated whether adding a beta-lactam to standard-of-care therapy would improve outcomes in adults with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. The rationale for this combination is the "seesaw effect," where MRSA strains with reduced susceptibility to glycopeptides often exhibit increased susceptibility to beta-lactams. However, the trial was terminated early in 2019 after enrolling 352 participants because the combination therapy group showed a significantly higher incidence of acute kidney injury (AKI) without a corresponding improvement in the primary composite endpoint of mortality or persistent bacteraemia.

Other names

beta-lactam-Menzies School of Health Research-methicillin-resistant Staphylococcus aureus bacteraemiadaptomycin + beta-lactamflucloxacillin + vancomycincefazolin + vancomycincloxacillin + vancomycin