From the Guidelines
Staphylococcus lugdunensis infections should be treated with antibiotics, with a recommended regimen of vancomycin or an anti-staphylococcal beta-lactam antimicrobial, and the catheter should be removed, as this approach is supported by the most recent and highest quality study 1. The treatment of Staphylococcus lugdunensis infection typically involves the use of antibiotics, with the specific regimen depending on the infection site and severity.
- For uncomplicated infections, beta-lactam antibiotics like oxacillin, nafcillin, or cefazolin are first-line treatments, as they are usually effective against S. lugdunensis, which is typically susceptible to methicillin 1.
- A typical regimen might include oxacillin 2g IV every 4 hours for 10-14 days for serious infections, or cephalexin 500mg orally four times daily for 7-10 days for milder cases.
- For patients with penicillin allergies, clindamycin 600mg IV every 8 hours or 300-450mg orally four times daily can be used.
- However, the most recent study 1 suggests that vancomycin is an appropriate antimicrobial to use empirically until identification and antimicrobial sensitivities are available, especially in severe illness or in patients with a femoral catheter.
- The decision to begin antimicrobials before cultures are positive should be based on clinical judgement and illness severity, and the length of antimicrobial therapy after catheter removal is often 7–14 days but varies with the pathogen and the degree of illness.
- Surgical drainage is essential for abscesses, and endocarditis caused by S. lugdunensis often requires valve replacement surgery alongside 4-6 weeks of antibiotic therapy.
- Antibiotic susceptibility testing is crucial for guiding definitive therapy, as resistance patterns can vary, and the approach to removal of a central catheter in a patient with bacteremia and a clear alternative focus should be individualized based on the organism and clinical circumstances 1.
From the Research
Treatment Options for Staphylococcus lugdunensis Infection
- Daptomycin has been used to treat Staphylococcus lugdunensis endocarditis, as reported in a study published in 2012 2.
- For skin infections, antibiotics such as amoxicillin/clavulanic acid, cefuroxime axetil, and doxycycline have been used, with a cure rate of 100% 3.
- S. lugdunensis remains highly susceptible to a wide range of antibacterial therapies, including oxacillin, which can be used to treat infections 4.
- In cases of aggressive infective endocarditis or bone/joint infection, treatment with a β-lactam agent is recommended 4.
- Antibiotic susceptibility testing is essential to guide treatment, as some isolates may be resistant to certain antibiotics, such as penicillin, gentamycin, and oxacillin 3, 5.
Specific Treatment Regimens
- Daptomycin has been used as a novel treatment regimen for Staphylococcus lugdunensis endocarditis 2.
- A combination of antibiotics, such as amoxicillin/clavulanic acid, cefuroxime axetil, and doxycycline, has been used to treat skin infections 3.
- Oxacillin and other β-lactam agents may be used to treat various types of S. lugdunensis infections, including skin and soft tissue infections, infective endocarditis, and bone/joint infections 4.