Combining Aminoglycosides with antistaphylococcal penicillins or vancomycin in SA bacteremia

Q: Aminoglycosides should be combined with antistaphylococcal penicillins or vancomycin for the treatment of Staphylococcus aureus (SA) bacteremia due to their synergistic effect? (select one) 

A) Yes 
B) No


Answer: B

Although it is true and was a popular and a recommended practice to combine aminoglycosides with antistaphylococcal penicillins or vancomycin for treatment of S. aureus bacteremia, recent data and guidelines suggest against it. It may do more rapid clearing of bacteremia but found to be associated with a higher incidence of kidney dysfunction.

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References:

Fowler VG Jr, Boucher HW, Corey GR, et al. Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus. N Engl J Med 2006; 355:653. 

Cosgrove SE, Vigliani GA, Fowler VG Jr, et al. Initial low-dose gentamicin for Staphylococcus aureus bacteremia and endocarditis is nephrotoxic. Clin Infect Dis 2009; 48:713.