Daptomycin for the treatment of infective endocarditis: results from a European registry.
| Autor: | Dohmen PM; Department of Cardiovascular Surgery, Charité Hospital, Medical University Berlin, Berlin, Germany. pascal.dohmen@yahoo.de, Guleri A, Capone A, Utili R, Seaton RA, González-Ramallo VJ, Pathan R, Heep M, Chaves RL |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2013 Apr; Vol. 68 (4), pp. 936-42. Date of Electronic Publication: 2012 Nov 28. |
| DOI: | 10.1093/jac/dks467 |
| Abstrakt: | Objectives: Infective endocarditis (IE) is a complex infection associated with high mortality. Daptomycin, a cyclic lipopeptide antibiotic highly active against Gram-positive bacteria, has recently been incorporated into IE treatment guidelines. This retrospective analysis provides insights into the use of daptomycin in IE in the European Cubicin(®) Outcomes Registry Experience (EU-CORE(SM)) between 2006 and 2010. Patients and Methods: Three hundred and seventy-eight (10%) of 3621 enrolled patients received daptomycin for treatment of IE. Two hundred and fifty-nine (69%) had left-sided IE (LIE) and 182 patients (48%) underwent concomitant surgery. Results: Staphylococcus aureus was the most frequently identified pathogen (n=92; methicillin susceptible, n=50) and daptomycin was used empirically in 134 patients. Among cases of second-line therapy (n=312), the most common reason for switching to daptomycin was failure of the previous regimen (including glycopeptides and penicillins). Daptomycin was administered at 6 mg/kg in 224 patients and at ≥ 8 mg/kg in 72 patients. Clinical success rates were 80% overall, 91% for right-sided IE (RIE) and 76% for LIE, with similar rates seen for infections caused by methicillin-susceptible S. aureus (84%) and methicillin-resistant S. aureus (81%). The clinical success rate in patients treated with ≥ 8 mg/kg daptomycin was 90% [n=72 (RIE, 91%; LIE, 89%)]. No new safety signals were observed. Conclusions: In patients with IE registered in EU-CORE, daptomycin was most frequently used as second-line treatment after treatment failure. The majority of patients had LIE and most commonly received daptomycin for the treatment of staphylococcal infections. Clinical success was high in this difficult-to-treat population. The role of doses ≥ 8 mg/kg per day in the empirical treatment of IE deserves further investigation. |
| Databáze: | MEDLINE |
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