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High-dose daptomycin therapy for left-sided infective endocarditis: a prospective study from the international collaboration on endocarditis.

Publication ,  Journal Article
Carugati, M; Bayer, AS; Miró, JM; Park, LP; Guimarães, AC; Skoutelis, A; Fortes, CQ; Durante-Mangoni, E; Hannan, MM; Nacinovich, F; Grossi, P ...
Published in: Antimicrob Agents Chemother
December 2013

The use of daptomycin in Gram-positive left-sided infective endocarditis (IE) has significantly increased. The purpose of this study was to assess the influence of high-dose daptomycin on the outcome of left-sided IE due to Gram-positive pathogens. This was a prospective cohort study based on 1,112 cases from the International Collaboration on Endocarditis (ICE)-Plus database and the ICE-Daptomycin Substudy database from 2008 to 2010. Among patients with left-sided IE due to Staphylococcus aureus, coagulase-negative staphylococci, and Enterococcus faecalis, we compared those treated with daptomycin (cohort A) to those treated with standard-of-care (SOC) antibiotics (cohort B). The primary outcome was in-hospital mortality. Time to clearance of bacteremia, 6-month mortality, and adverse events (AEs) ascribable to daptomycin were also assessed. There were 29 and 149 patients included in cohort A and cohort B, respectively. Baseline comorbidities did not differ between the two cohorts, except for a significantly higher prevalence of diabetes and previous episodes of IE among patients treated with daptomycin. The median daptomycin dose was 9.2 mg/kg of body weight/day. Two-thirds of the patients treated with daptomycin had failed a previous antibiotic regimen. In-hospital and 6-month mortalities were similar in the two cohorts. In cohort A, median time to clearance of methicillin-resistant S. aureus (MRSA) bacteremia was 1.0 day, irrespective of daptomycin dose, representing a significantly faster bacteremia clearance compared to SOC (1.0 versus 5.0 days; P < 0.01). Regimens with higher daptomycin doses were not associated with increased incidence of AEs. In conclusion, higher-dose daptomycin may be an effective and safe alternative to SOC in the treatment of left-sided IE due to common Gram-positive pathogens.

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Published In

Antimicrob Agents Chemother

DOI

EISSN

1098-6596

Publication Date

December 2013

Volume

57

Issue

12

Start / End Page

6213 / 6222

Location

United States

Related Subject Headings

  • Staphylococcus aureus
  • Prospective Studies
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Female
  • Enterococcus faecalis
  • Endocarditis, Bacterial
  • Daptomycin
 

Citation

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Chicago
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Carugati, M., Bayer, A. S., Miró, J. M., Park, L. P., Guimarães, A. C., Skoutelis, A., … International Collaboration on Endocarditis, . (2013). High-dose daptomycin therapy for left-sided infective endocarditis: a prospective study from the international collaboration on endocarditis. Antimicrob Agents Chemother, 57(12), 6213–6222. https://doi.org/10.1128/AAC.01563-13
Carugati, Manuela, Arnold S. Bayer, Josè M. Miró, Lawrence P. Park, Armenio C. Guimarães, Athanasios Skoutelis, Claudio Q. Fortes, et al. “High-dose daptomycin therapy for left-sided infective endocarditis: a prospective study from the international collaboration on endocarditis.Antimicrob Agents Chemother 57, no. 12 (December 2013): 6213–22. https://doi.org/10.1128/AAC.01563-13.
Carugati M, Bayer AS, Miró JM, Park LP, Guimarães AC, Skoutelis A, et al. High-dose daptomycin therapy for left-sided infective endocarditis: a prospective study from the international collaboration on endocarditis. Antimicrob Agents Chemother. 2013 Dec;57(12):6213–22.
Carugati, Manuela, et al. “High-dose daptomycin therapy for left-sided infective endocarditis: a prospective study from the international collaboration on endocarditis.Antimicrob Agents Chemother, vol. 57, no. 12, Dec. 2013, pp. 6213–22. Pubmed, doi:10.1128/AAC.01563-13.
Carugati M, Bayer AS, Miró JM, Park LP, Guimarães AC, Skoutelis A, Fortes CQ, Durante-Mangoni E, Hannan MM, Nacinovich F, Fernández-Hidalgo N, Grossi P, Tan R-S, Holland T, Fowler VG, Corey RG, Chu VH, International Collaboration on Endocarditis. High-dose daptomycin therapy for left-sided infective endocarditis: a prospective study from the international collaboration on endocarditis. Antimicrob Agents Chemother. 2013 Dec;57(12):6213–6222.

Published In

Antimicrob Agents Chemother

DOI

EISSN

1098-6596

Publication Date

December 2013

Volume

57

Issue

12

Start / End Page

6213 / 6222

Location

United States

Related Subject Headings

  • Staphylococcus aureus
  • Prospective Studies
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Female
  • Enterococcus faecalis
  • Endocarditis, Bacterial
  • Daptomycin