Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis?
Abstract Introduction Previous series on the use of daptomycin in enterococcal infective endocarditis (EIE) have shown various outcomes, including higher mortality rates. We analyzed the effectiveness of high-dose daptomycin for the treatment of EIE. Methods We performed a prospective study from 201...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2019-08-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | http://link.springer.com/article/10.1007/s40121-019-00261-w |
| _version_ | 1818148676322721792 |
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| author | Maddalena Peghin Alessandro Russo Filippo Givone Martina Ingani Elena Graziano Matteo Bassetti |
| author_facet | Maddalena Peghin Alessandro Russo Filippo Givone Martina Ingani Elena Graziano Matteo Bassetti |
| author_sort | Maddalena Peghin |
| collection | DOAJ |
| description | Abstract Introduction Previous series on the use of daptomycin in enterococcal infective endocarditis (EIE) have shown various outcomes, including higher mortality rates. We analyzed the effectiveness of high-dose daptomycin for the treatment of EIE. Methods We performed a prospective study from 2010 to 2018 in a referral center in patients with native (NVE) and prosthetic valve endocarditis (PVE) due to Enterococcus spp. The standard high-dose daptomycin at our institution is 10–12 mg/kg/day (CLCr > 30 ml/min). We compared the efficacy of a daptomycin-based regimen (DBR) versus daptomycin-sparing regimen (DSR) and daptomycin monotherapy versus combination therapy. Primary endpoints of the study were evaluation of risk factors associated with 30-day mortality and failure at end of therapy. Results We collected 43 EIE cases; 29 were NVE (67.4%). Overall, 16 (37.2%) were treated with DBR, mainly with combination regimens (11, 68.7%), in the majority of cases in association with ß-lactam (7, 43.7%). The mean administered dose of daptomycin was 10.125 mg/kg/day (range 8–12 mg/kg/day). Overall, patients treated with DBR compared with patients treated with DSR had no higher mortality rates and/or failure at end of therapy (6.2% vs. 22. 2%; P 0.41 and MICs 0.25–2 mg/l, 6.2% vs. 3.7%; P 1.0). In the sub-group of patients with NVE and PVE treated with DBR and DSR, no difference was found regarding the primary endpoints on the single or combined use of daptomycin. Conclusion Our findings suggest that high-dose daptomycin might be used as an alternative treatment regimen in EIE. |
| first_indexed | 2024-12-11T12:54:55Z |
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| institution | Directory Open Access Journal |
| issn | 2193-8229 2193-6382 |
| language | English |
| last_indexed | 2024-12-11T12:54:55Z |
| publishDate | 2019-08-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj.art-e57834748fef422584f693fe8d0323352022-12-22T01:06:36ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822019-08-018469570210.1007/s40121-019-00261-wShould High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis?Maddalena Peghin0Alessandro Russo1Filippo Givone2Martina Ingani3Elena Graziano4Matteo Bassetti5Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di UdineInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di UdineInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di UdineInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di UdineInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di UdineInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di UdineAbstract Introduction Previous series on the use of daptomycin in enterococcal infective endocarditis (EIE) have shown various outcomes, including higher mortality rates. We analyzed the effectiveness of high-dose daptomycin for the treatment of EIE. Methods We performed a prospective study from 2010 to 2018 in a referral center in patients with native (NVE) and prosthetic valve endocarditis (PVE) due to Enterococcus spp. The standard high-dose daptomycin at our institution is 10–12 mg/kg/day (CLCr > 30 ml/min). We compared the efficacy of a daptomycin-based regimen (DBR) versus daptomycin-sparing regimen (DSR) and daptomycin monotherapy versus combination therapy. Primary endpoints of the study were evaluation of risk factors associated with 30-day mortality and failure at end of therapy. Results We collected 43 EIE cases; 29 were NVE (67.4%). Overall, 16 (37.2%) were treated with DBR, mainly with combination regimens (11, 68.7%), in the majority of cases in association with ß-lactam (7, 43.7%). The mean administered dose of daptomycin was 10.125 mg/kg/day (range 8–12 mg/kg/day). Overall, patients treated with DBR compared with patients treated with DSR had no higher mortality rates and/or failure at end of therapy (6.2% vs. 22. 2%; P 0.41 and MICs 0.25–2 mg/l, 6.2% vs. 3.7%; P 1.0). In the sub-group of patients with NVE and PVE treated with DBR and DSR, no difference was found regarding the primary endpoints on the single or combined use of daptomycin. Conclusion Our findings suggest that high-dose daptomycin might be used as an alternative treatment regimen in EIE.http://link.springer.com/article/10.1007/s40121-019-00261-wDaptomycinEnterococcal infective endocarditisEnterococcus spp.High-dose daptomycin |
| spellingShingle | Maddalena Peghin Alessandro Russo Filippo Givone Martina Ingani Elena Graziano Matteo Bassetti Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis? Infectious Diseases and Therapy Daptomycin Enterococcal infective endocarditis Enterococcus spp. High-dose daptomycin |
| title | Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis? |
| title_full | Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis? |
| title_fullStr | Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis? |
| title_full_unstemmed | Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis? |
| title_short | Should High-dose Daptomycin be an Alternative Treatment Regimen for Enterococcal Endocarditis? |
| title_sort | should high dose daptomycin be an alternative treatment regimen for enterococcal endocarditis |
| topic | Daptomycin Enterococcal infective endocarditis Enterococcus spp. High-dose daptomycin |
| url | http://link.springer.com/article/10.1007/s40121-019-00261-w |
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