Treatment of Intracranial Infection Caused by Methicillin-Resistant Staphylococcus epidermidis with Linezolid Following Poor Outcome of Vancomycin Therapy: A Case Report and Literature Review

The pharmacokinetic/pharmacodynamic (PK/PD) parameter for evaluating the efficacy of vancomycin is now recommended to target an AUC/MIC (area under curve, AUC; minimum inhibitory concentration, MIC) ratio 400 600, and trough concentration should not be used as a substitute. We report case intracranial infection caused by methicillin-resistant Staphylococcus epidermidis (MRSE), which was sensitive (MIC=2µg/mL) linezolid (MIC=4µg/mL). in serum 18.3 µg/mL, CSF 5.0 all within normal range. However, calculated 125 mg·h·L-1, unable reach AUC/MIC. Vancomycin replaced with after 36 days treatment due poor outcome, patient eventually cured. Further, 23 cases aureus (MRSA) or coagulase-negative (MRCoNS) infections were reported, 1 MRSA had MIC while remaining 22 MICs >1 µg/mL. linezolid-containing regimen drug susceptibility results if initial failed, leading recovery 19 patients, microbial clearance 3 failure case. In conclusion, dosing based on AUC-guided monitoring. When MRSA/MRCoNS may achieved. such cases, can effectively considered good alternative vancomycin.