Daptomycin for the treatment of infective endocarditis: Results from a European registry

Pascal M. Dohmen, Achyut Guleri, Alessandro Capone, Riccardo Utili, R. Andrew Seaton, Víctor José González-Ramallo, Rashidkhan Pathan, Markus Heep, Ricardo L. Chaves

Research output: Contribution to journalArticle

Abstract

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 Cubicinw Outcomes Registry Experience (EU-CORESM) 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 (n312), 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.

Original languageEnglish
Article numberdks467
Pages (from-to)936-942
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume68
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Clinical success
  • Gram-positive infections
  • Lipopeptides
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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    Dohmen, P. M., Guleri, A., Capone, A., Utili, R., Seaton, R. A., González-Ramallo, V. J., Pathan, R., Heep, M., & Chaves, R. L. (2013). Daptomycin for the treatment of infective endocarditis: Results from a European registry. Journal of Antimicrobial Chemotherapy, 68(4), 936-942. [dks467]. https://doi.org/10.1093/jac/dks467