Clinical experience with daptomycin in Europe: the first 2.5 years

• Published in: Journal of antimicrobial chemotherapy 2011-04, Vol.66 (4), p.912-919
• Main Authors: GONZALEZ-RUIZ, Armando, BEIRAS-FERNANDEZ, Andres, LEHMKUHL, Hans, ANDREW SEATON, R, LOEFFLER, Juergen, CHAVES, Ricardo L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Child; Child, Preschool; Daptomycin - adverse effects; Daptomycin - therapeutic use; Enterococcus faecium; Enterococcus faecium - drug effects; Enterococcus faecium - isolation & purification; Europe; Female; Gram-positive bacteria; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Humans; Infant; Male; Medical sciences; Medical treatment; Middle Aged; Original Research; Pharmacology. Drug treatments; Retrospective Studies; Staphylococcus - drug effects; Staphylococcus - isolation & purification; Staphylococcus aureus; Staphylococcus infections; Tissues; Toxicity; Treatment Outcome; Young Adult
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkq528

To describe the patient populations and infections being treated with daptomycin, as well as the efficacy and safety outcomes. Data from the European Cubicin Outcomes Registry and Experience (EU-CORESM), retrospectively collected at 118 institutions between January 2006 and August 2008, were analysed. Daptomycin treatment was documented in 1127 patients with diverse infections, including complicated skin and soft tissue infections (33%), bacteraemia (22%), endocarditis (12%) and osteomyelitis (6%). It was used empirically, before microbiological results became available, in 53% of patients. Staphylococcus aureus was the most common pathogen (34%), with 52% of isolates resistant to methicillin; coagulase-negative staphylococci and enterococci were also frequent, with 22% of Enterococcus faecium isolates resistant to vancomycin. Daptomycin was used as first-line therapy in 302 (27%) patients. When used second line, the most common reasons for discontinuation of previous antibiotic were treatment failure and toxicity or intolerance. The use of concomitant antibiotics was reported in 65% of patients. Most frequent doses were 6 mg/kg (47%) and 4 mg/kg (32%). The median duration of daptomycin therapy was 10 days (range 1-246 days) in the inpatient setting and 13 days (range 2-189 days) in the outpatient setting. The overall clinical success rate was 79%, with a clinical failure rate of