Pharmacologic options for CNS infections caused by resistant Gram-positive organisms

Abstract

Infectious disease continues to evolve, presenting new and challenging clinical situations for practitioners. Specific to device-related and neurosurgical-related CNS infections, Gram-positive organisms are of growing concern. Current Infection Disease Society of America guidelines for the treatment of CNS infections offer little direction after conventional therapy, consisting of vancomycin, has failed or the patient has demonstrated intolerance. A review of literature evaluating alternative therapies, specifically linezolid, quinupristin/dalfopristin, daptomycin and tigecycline, will be presented. Interpretations of these data are offered followed by a brief presentation of future therapies, including oritavancin, telavancin, dalbavancin, ceftobiprole and iclaprim, all of which possess potent Gram-positive activity.

Keywords::

• CNS infection
• daptomycin
• linezolid
• meningitis
• MRSA
• quinupristin/dalfopristin
• tigecycline
• vancomycin
• ventriculitis
• VRE

Financial & competing interests disclosure

William J Peppard: Speakers Bureau, Pfizer Inc.. Angela /urmanski: Speakers Bureau, Pfizer Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.