Daptomycin for treatment of methicillin-resistant Staphylococcus epidermidis saphenectomy wound infection after coronary artery bypass graft operation (CABG): a case report

Since its first clinical use by Rene Favaloro in the 60's, the great saphenous vein has become the most commonly harvested conduit for revascularization in coronary artery bypass grafting (CABG) [1]. In order to reduce morbidity and improve the recovery time associated with CABG procedures, various techniques have been developed including conventional conduit harvesting, minimally invasive and/or endoscopic harvesting procedures [2]. Still, these surgical techniques are associated with significant complication rates e.g. wound infections, non-infective wound healing disturbances, postoperative pain, etc. [3]. Avoiding and/or reducing these complication rates is of great medical and economic interest. Improvements would result in increased postoperative mobility and quality of life as well as reduced length of hospital stay following surgery resulting large cost savings. Although much research has focused on comparing less invasive and conventional harvest techniques, there is at present no consensus on the areas of postoperative antibiotic drug treatment of saphenectomy wound infections once an infection occurs. Further studies are required to compare treatment methods of saphenectomy wound infections by different antibiotic drugs. Although, Daptomycin has already been proven to be effective in the treatment of bacteremia and endocarditis [4,5] caused by methilin-resistent Staphylococcus aureus [6,7] and several case reports about its effectiveness in the field of cardiac surgery exist in the literature [8], there are still no cases describing the successful treatment of saphenectomy wound infections by Daptomycin.Therefore, in this paper we report the first case of successful treatment of a postoperative wound infection after saphenectomy of the great saphenous vein of the upper left leg with the new antibiotic drug Daptomycin (Cubicin？, Novartis Pharma Corporation, Germany).We report the case of a 68-year old man with severe, diffuse coronary artery disease who pr