Nafcillin Augmentation of Daptomycin and Cathelicidin LL-37 Killing of Methicillin-resistant Staphylococcus epidermidis: Foundations of Successful Therapy of Endocarditis.
Catteau. Lucy L; Iglesias. Yvan Diaz YD; Tsunemoto. Hannah H; Pogliano. Joseph J; Van Bambeke. Françoise F; Nizet. Victor V; Sakoulas. George G
Key Findings
- Nafcillin enhances daptomycin killing of MRSE in planktonic cells and biofilms
- Nafcillin sensitizes MRSE to human neutrophils and the innate peptide LL‑37
- Nafcillin (and ceftaroline) increase surface binding of daptomycin and LL‑37 to MRSE
Practical Outcomes
- For those interested in antimicrobial strategies, pairing a beta‑lactam such as nafcillin or ceftaroline with daptomycin may boost the effectiveness of both the drug and the body’s own peptide LL‑37 against resistant Staph epidermidis. This approach is still experimental and should only be considered under medical supervision, not as a self‑administered protocol for general health.
Summary
The study shows that the antibiotic nafcillin can make the resistant bacteria MRSE more vulnerable to both another antibiotic (daptomycin) and the body’s own antimicrobial peptide LL‑37, improving killing in lab tests and biofilms. This suggests a combo of a beta‑lactam (like nafcillin or ceftaroline) with daptomycin could be more effective against tough infections, but it’s mainly a clinical insight, not a DIY health hack.
Abstract
Methicillin-resistant Staphylococcus epidermidis (MRSE) endocarditis failing conventional therapy has been successfully treated with nafcillin plus daptomycin in the clinic. In vitro studies showed that nafcillin enhanced daptomycin killing of MRSE in both planktonic cells and biofilm. Nafcillin exposure also sensitized MRSE to killing by human neutrophils and cathelicidin antimicrobial peptide LL-37. Fluorescent microscopy showed increased daptomycin and LL-37 binding to the MRSE bacterial surface upon nafcillin treatment. Ceftaroline also increased MRSE killing by daptomycin in planktonic cultures and biofilms, as well as daptomycin and LL-37 binding on the bacterial surface. Nafcillin, ceftaroline, and possibly other β-lactams, may serve an important role in the therapy of MRSE endocarditis through augmentation of cationic peptide, the innate immune system, and daptomycin killing. Clinical studies will be needed to determine how early these regimens should be deployed to optimize clinical outcome.
Study Information
pubmed
2023
2023-02-10T00:00:00.000Z
10.1016/j.ijantimicag.2023.106758
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