Successful Treatment of Methicillin-Resistant Staphylococcus aureus Vertebral Osteomyelitis With Outpatient Oritavancin Therapy.

Native vertebral osteomyelitis (NVO) is a difficult to treat infection often caused by hematogenous spread of bacteria to the bone, causing pain and inflammation. The Infectious Diseases Society of America recommends vancomycin intravenously as first-line treatment for NVO involving methicillin-resistant Staphylococcus aureus (MRSA) for 6 weeks. Alternatives include daptomycin and linezolid. Oritavancin (Orbactiv) is a lipoglypoglycopeptide, structurally similar to vancomycin approved by the Food and Drug Administration for the treatment of acute bacterial skin and skin structure infections caused by susceptible bacteria including S. aureus (both methicillin sensitive and resistant), Streptocococcus, and Enterococcus species. The clinical features of oritavancin are favorable for outpatient use given its broad spectrum of activity for gram-positive organisms and ease of administration; however, clinical experience with the medication is lacking. In this case report, we describe a patient presentation and the evidence for use of oritavancin for the treatment of NVO caused by MRSA. To our knowledge, this is the first reported case of oritavancin for NVO caused by MRSA, and further clinical studies to evaluate it for other indications should be considered. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

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