What is the treatment for Staphylococcus lugdunensis infection?

From the Guidelines

The treatment for Staphylococcus lugdunensis infections typically involves antibiotics, with the specific regimen depending on the infection site and severity, and should be treated aggressively with intravenous antibiotics such as vancomycin or daptomycin for 4-6 weeks for endocarditis or bone/joint infections. For uncomplicated skin and soft tissue infections, oral antibiotics such as dicloxacillin, cephalexin, or trimethoprim-sulfamethoxazole are often effective 1. However, for more severe infections like bacteremia, endocarditis, or deep-seated infections, intravenous antibiotics are necessary, typically starting with vancomycin (15-20 mg/kg every 8-12 hours) or daptomycin (6-10 mg/kg daily) while awaiting susceptibility results 1. Unlike some other coagulase-negative staphylococci, S. lugdunensis is often more virulent and should be treated aggressively rather than dismissed as a contaminant 1. Some key points to consider in the treatment of Staphylococcus lugdunensis infections include:

• Surgical drainage may be necessary for abscesses
• Infected prosthetic devices often require removal in addition to antibiotic therapy
• Treatment duration varies from 7-14 days for simple infections to 4-6 weeks for endocarditis or bone/joint infections
• Regular follow-up is essential to ensure resolution of the infection It's also important to note that the treatment regimen may vary depending on the specific circumstances of the infection, such as the presence of prosthetic material or the patient's allergy status 1. In general, the treatment of Staphylococcus lugdunensis infections requires a comprehensive approach that takes into account the severity of the infection, the presence of any underlying medical conditions, and the potential for complications. The most recent and highest quality study, which is from 2015 1, provides the most up-to-date guidance on the treatment of Staphylococcus lugdunensis infections.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Bacteriologic studies to determine the causative organisms and their susceptibility to oxacillin should always be performed. In severe staphylococcal infections, therapy with oxacillin should be continued for at least 14 days.

The treatment for Staphylococcus lugdunensis infection is not directly stated in the provided drug labels. However, since Staphylococcus lugdunensis is a type of staphylococcal infection, the dosage and administration of oxacillin for severe staphylococcal infections can be considered. The recommended dosage is 250 to 500 mg IM or IV every 4 to 6 hours for mild to moderate infections, and 1 gram IM or IV every 4 to 6 hours for severe infections. Therapy should be continued for at least 14 days in severe staphylococcal infections, and for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative 2.

From the Research

Treatment Options for Staphylococcus lugdunensis Infection

• The treatment for Staphylococcus lugdunensis infection typically involves the use of antibiotics, with the specific choice of antibiotic depending on the severity and location of the infection 3, 4, 5, 6, 7.
• Daptomycin has been used successfully to treat Staphylococcus lugdunensis endocarditis, demonstrating its effectiveness in severe cases 3.
• Penicillin G may be a more optimal treatment choice than oxacillin for Staphylococcus lugdunensis infections, as it has been shown to have lower MIC50 and MIC90 values 4.
• Other antibiotics that have been used to treat Staphylococcus lugdunensis infections include amoxicillin/clavulanic acid, cefuroxime axetil, and doxycycline, with a high cure rate reported 6.
• In cases of aggressive infective endocarditis or bone/joint infection, treatment with a β-lactam agent is recommended 7.

Antibiotic Susceptibility

• Staphylococcus lugdunensis remains highly susceptible to a wide range of antibacterial therapies, including oxacillin, penicillin G, and other antibiotics 4, 5, 6, 7.
• However, resistance to penicillin and clindamycin has been observed in some cases, highlighting the need for continued monitoring and antimicrobial stewardship 6.
• The breakpoints for Staphylococcus lugdunensis are higher than those of other coagulase-negative staphylococci and similar to Staphylococcus aureus breakpoints 7.

Clinical Considerations

• Staphylococcus lugdunensis infections can present similarly to Staphylococcus aureus infections, necessitating species-level differentiation for proper diagnosis 7.
• Imaging modalities, such as fluorodeoxyglucose with positron emission tomography, may be useful in the diagnosis of Staphylococcus lugdunensis infections 7.
• Surgical drainage may be necessary in addition to antibiotic therapy for certain types of infections, such as abscesses or surgical wound infections 5, 6.