From the Research
Vancomycin is the first-line antibiotic for treating Corynebacterium striatum infections, typically administered at 15-20 mg/kg IV every 8-12 hours, with dosing adjusted based on serum levels and renal function. For less severe infections, linezolid (600 mg IV/oral twice daily) is an effective alternative 1, 2. C. striatum has become increasingly resistant to many antibiotics including penicillins, cephalosporins, macrolides, and fluoroquinolones, making susceptibility testing crucial before finalizing treatment 2.
Key Considerations
- Daptomycin should be avoided due to the risk of development of high-level resistance and clinical failure, even when isolates appear susceptible 1, 3.
- Combination therapy may be necessary for severe or persistent infections, often pairing vancomycin with rifampin (600 mg daily) or gentamicin (based on weight and renal function) 2, 4.
- Treatment duration typically ranges from 10-14 days for uncomplicated infections to 4-6 weeks for more severe cases like endocarditis or osteomyelitis 2, 5.
- C. striatum, once considered a contaminant, is now recognized as a significant pathogen, particularly in healthcare settings and immunocompromised patients, with the ability to form biofilms that enhance its antibiotic resistance and persistence in medical devices and wounds 1, 5.
Antibiotic Resistance and Treatment Failure
- The emergence of daptomycin nonsusceptibility and treatment failure in patients with Corynebacterium striatum bacteremia has been reported, highlighting the need for careful selection of antibiotics 3.
- Vancomycin and linezolid are effective against C. striatum, with vancomycin being the preferred first-line treatment due to its efficacy and safety profile 1, 2.