Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study
Background: Ampicillin resistant and glycopeptide susceptible <i>Enterococcus faecium</i> bloodstream infection (GSEF-BSI) incidence has risen. However, the treatment of choice remains unknown. Daptomycin use for the treatment of enterococcal infections has increased, despite effectivene...
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MDPI AG
2021-06-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/6/716 |
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| author | Daniel Echeverría-Esnal Luisa Sorli Nuria Prim Clara Martin-Ontiyuelo Juan Pablo Horcajada Santiago Grau |
| author_facet | Daniel Echeverría-Esnal Luisa Sorli Nuria Prim Clara Martin-Ontiyuelo Juan Pablo Horcajada Santiago Grau |
| author_sort | Daniel Echeverría-Esnal |
| collection | DOAJ |
| description | Background: Ampicillin resistant and glycopeptide susceptible <i>Enterococcus faecium</i> bloodstream infection (GSEF-BSI) incidence has risen. However, the treatment of choice remains unknown. Daptomycin use for the treatment of enterococcal infections has increased, despite effectiveness and safety concerns. The objective was to compare the effectiveness and safety of daptomycin and glycopeptides in the treatment of GSEF-BSI. Methods: This was a single-centre, retrospective observational cohort study performed at Hospital del Mar (Barcelona, Spain), from January 2006–May 2018. The primary outcome was clinical cure at the end of the therapy, and secondary outcomes included 14-day, 30-day, in-hospital mortality, and length of stay. Results: From a total of 192 patients with GSEF-BSI, 54 (28.1%) were treated with glycopeptides and 17 (8.9%) with daptomycin. Patients treated with daptomycin presented a lower clinical cure than patients treated with glycopeptides (58.8% vs. 83.3%, RR 0.416 (95% CI 0.189–0.915)). After controlling for confounding variables by means of multivariate analysis the significative difference was confirmed (aOR 4.313, 95% CI, 1.053–17.660). The need for treatment discontinuation due to adverse events was similar. Conclusions: Patients with GSEF-BSI treated with glycopeptides showed a higher clinical cure than those treated with daptomycin. |
| first_indexed | 2024-03-10T10:25:35Z |
| format | Article |
| id | doaj.art-9684b3da947d46a691a31203699ef365 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T10:25:35Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-9684b3da947d46a691a31203699ef3652023-11-22T00:04:26ZengMDPI AGAntibiotics2079-63822021-06-0110671610.3390/antibiotics10060716Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort StudyDaniel Echeverría-Esnal0Luisa Sorli1Nuria Prim2Clara Martin-Ontiyuelo3Juan Pablo Horcajada4Santiago Grau5Pharmacy Department, Hospital del Mar, Passeig Maritim 25–29, 08003 Barcelona, SpainInfectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Dr. Aiguader 88, 08003 Barcelona, SpainMicrobiology Department, Laboratori de Referència de Catalunya, Carrer de la Selva 10, 08820 Barcelona, SpainPneumology Department, Hospital del Mar, Passeig Marítim 25, 08003 Barcelona, SpainInfectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Dr. Aiguader 88, 08003 Barcelona, SpainPharmacy Department, Hospital del Mar, Passeig Maritim 25–29, 08003 Barcelona, SpainBackground: Ampicillin resistant and glycopeptide susceptible <i>Enterococcus faecium</i> bloodstream infection (GSEF-BSI) incidence has risen. However, the treatment of choice remains unknown. Daptomycin use for the treatment of enterococcal infections has increased, despite effectiveness and safety concerns. The objective was to compare the effectiveness and safety of daptomycin and glycopeptides in the treatment of GSEF-BSI. Methods: This was a single-centre, retrospective observational cohort study performed at Hospital del Mar (Barcelona, Spain), from January 2006–May 2018. The primary outcome was clinical cure at the end of the therapy, and secondary outcomes included 14-day, 30-day, in-hospital mortality, and length of stay. Results: From a total of 192 patients with GSEF-BSI, 54 (28.1%) were treated with glycopeptides and 17 (8.9%) with daptomycin. Patients treated with daptomycin presented a lower clinical cure than patients treated with glycopeptides (58.8% vs. 83.3%, RR 0.416 (95% CI 0.189–0.915)). After controlling for confounding variables by means of multivariate analysis the significative difference was confirmed (aOR 4.313, 95% CI, 1.053–17.660). The need for treatment discontinuation due to adverse events was similar. Conclusions: Patients with GSEF-BSI treated with glycopeptides showed a higher clinical cure than those treated with daptomycin.https://www.mdpi.com/2079-6382/10/6/716<i>Enterococcus faecium</i>bloodstream infectionbacteraemiadaptomycinglycopeptidesvancomycin |
| spellingShingle | Daniel Echeverría-Esnal Luisa Sorli Nuria Prim Clara Martin-Ontiyuelo Juan Pablo Horcajada Santiago Grau Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study Antibiotics <i>Enterococcus faecium</i> bloodstream infection bacteraemia daptomycin glycopeptides vancomycin |
| title | Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study |
| title_full | Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study |
| title_fullStr | Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study |
| title_full_unstemmed | Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study |
| title_short | Daptomycin versus Glycopeptides for the Treatment of <i>Enterococcus faecium</i> Bacteraemia: A Cohort Study |
| title_sort | daptomycin versus glycopeptides for the treatment of i enterococcus faecium i bacteraemia a cohort study |
| topic | <i>Enterococcus faecium</i> bloodstream infection bacteraemia daptomycin glycopeptides vancomycin |
| url | https://www.mdpi.com/2079-6382/10/6/716 |
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