The Combination of Daptomycin with Fosfomycin is More Effective than Daptomycin Alone in Reducing Mortality of Vancomycin-Resistant Enterococcal Bloodstream Infections: A Retrospective, Comparative Cohort Study

Autor: Tai-Chung Tseng, Yu-Chung Chuang, Jia-Ling Yang, Chi-Ying Lin, Sung-Hsi Huang, Jann-Tay Wang, Yee-Chun Chen, Shan-Chwen Chang
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Infectious Diseases and Therapy, Vol 12, Iss 2, Pp 589-606 (2023)
Druh dokumentu: article
ISSN: 2193-8229
2193-6382
DOI: 10.1007/s40121-022-00754-1
Popis: Abstract Introduction High-dose daptomycin-based combinations are recommended for vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Preclinical data have shown a synergistic effect of daptomycin/fosfomycin combinations against VRE. However, clinical studies comparing daptomycin monotherapy with daptomycin/fosfomycin combinations are unavailable. Methods An observational study of VRE-BSI was performed between 2010–2021 on patients receiving daptomycin monotherapy (≥ 8 mg/kg) or daptomycin combined with intravenous fosfomycin. Patients treated with concomitant β-lactam combinations were excluded. The primary outcome was in-hospital mortality. Outcomes were analyzed using multivariable logistic regression and augmented inverse probability weighting (AIPW) analyses. Results Among 224 patients, 176 received daptomycin monotherapy, and 48 received fosfomycin combinations. The median daptomycin and fosfomycin doses were 9.8 mg/kg and 12 g/day, respectively. In-hospital mortality was 77.3% and 47.9% in the daptomycin monotherapy and fosfomycin combination groups (P
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