The Clinical Significance of Tolerance of Staphylococcus aureus
Authors: DONALD KAYE
Journal: Annals of Internal Medicine (1980)

Editorials1 December 1980The Clinical Significance of Tolerance of Staphylococcus aureusDONALD KAYE, M.D.DONALD KAYE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-6-924 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe article in this issue by Rajashekaraiah and co-workers (1) raises the issue of the clinical significance of a laboratory phenomenon, tolerance ofStaphylococcus aureusto beta-lactam antibiotics. Three questions must be addressed in evaluating the observations of these authors, who concluded that tolerance ofS. aureusto penicillinase-resistant penicillins and cephalosporins leads to poor results in therapy ofS. aureusendocarditis. They are [1] what exactly is tolerance, and how frequently does it occur? [2] What is the evidence that it has clinical significance? [3] What should be the approach to patients with endocarditis caused by tolerantS. aureus?...References1. RAJASHEKARAIAHRICERAOMARSHRAMAKRISHNAKALLICK KTVDBC. The clinical significance of tolerant strains of Staphylococcal aureus in patients with endocarditis. Ann Intern Med. 1980;93:796-801. LinkGoogle Scholar2. BESTKOVALBEST GAN. Susceptibility of clinical isolates of Staphylococcus aureus to killing by oxacillin. Can J Microbiol. 1975;21:1692-7. CrossrefMedlineGoogle Scholar3. MAYHALLMEDOFFMARR CGJ. Variation in the susceptibility of strains of Staphylococcus aureus to oxacillin, cephalothin, and gentamicin. Antimicrob Agents Chemother. 1976;10:707-12. CrossrefMedlineGoogle Scholar4. SABATHWHEELERLAVERDIEREBLAZEVICWILKINSON LNMDB. A new type of penicillin resistance of Staphylococcus aureus. Lancet. 1977;1:443-7. CrossrefMedlineGoogle Scholar5. DENNYPETERSONGERDINGHALL ALDW. Serious staphylococcal infections with strains tolerant to bactericidal antibiotics. 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Lancet. 1979; 1:150. Letter. CrossrefMedlineGoogle Scholar12. FAVILLEZASKEKAPLANCROSSLEYSABATHQUIE RDEKLP. Staphylococcus aureus endocarditis: combined therapy with vancomycin and rifampin. JAMA. 1978;240:1963-5. CrossrefMedlineGoogle Scholar13. GOLDMANPETERSDORF PR. Significance of methicillin tolerance in experimental staphylococcal endocarditis. Antimicrob Agents Chemother. 1979;15:802-6. CrossrefMedlineGoogle Scholar14. REYMANNHOLLEYCOBBS MHC. Persistent bacteremia in staphylococcal endocarditis. Am J Med. 1978;65:729-37. CrossrefMedlineGoogle Scholar15. SANDEJOHNSON MM. Antimicrobial therapy of experimental endocarditis caused by Staphylococcus aureus. J Infect Dis. 1975;131:367-75. CrossrefMedlineGoogle Scholar16. ABRAMSSKLAVERHOFFMANGREENMAN BATR. Single or combination therapy of staphylococcal endocarditis in intravenous drug abusers. Ann Intern Med. 1979;90:789-91. LinkGoogle Scholar17. WATANAKUNAKORNBAIRD CI. Prognostic factors in Staphylococcus aureus endocarditis and results of therapy with a penicillin and gentamicin. Am J Med Sci. 1977;273:133-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. 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