Failure of a Once-Daily Regimen of Cefonicid for Treatment of Endocarditis Due to Staphylococcus aureus

Abstract

Cefonicid, a new long-acting cephalosporin, was evaluated for treatment of endocarditis due to Staphylococcus aureus. Four patients, all with infection of the tricuspid valve, were treated with a single daily injection. By the fifth day of therapy, three of the four patients continued to have spiking fevers and positive blood cultures, and treatment with cefonicid was discontinued. Even though peak concentrations of antibiotic in serum were >20–40 times the minimum inhibitory concentration of the antibiotic for the infecting organism, serum bactericidal titers were S. aureus and should not be used for treatment of bacteremia or life-threatening infections known or suspected to be caused by this organism.