Abstract
BackgroundPooled data from two large registries, Cubicin® Outcomes Registry and Experience (CORE; USA) and European Cubicin® Outcomes Registry and Experience (EU-CORE; Europe, Latin America, and Asia), were analyzed to determine the characteristics and clinical outcomes of daptomycin therapy in patients with Gram-positive infections across wide geographical regions.MethodsPatients receiving at least one dose of daptomycin between 2004 and 2012 for the treatment of Gram-positive infections were included. Clinical success was defined as an outcome of ‘cured’ or ‘improved’. Post-treatment follow-up data were collected for a subset of patients (CORE: osteomyelitis and orthopedic foreign body device infection; EU-CORE: endocarditis, intracardiac/intravascular device infection, osteomyelitis, and orthopedic device infection). Safety was assessed for up to 30 days after daptomycin treatment.ResultsIn 11,557 patients (CORE, 5482; EU-CORE, 6075) treated with daptomycin (median age, 62 [range, 1–103] years), the most frequent underlying conditions were cardiovascular disease (54.7 %) and diabetes mellitus (28.0 %). The most commonly treated primary infections were complicated skin and soft tissue infection (cSSTI; 31.2 %) and bacteremia (21.8 %). The overall clinical success rate was 77.2 % (uncomplicated SSTI, 88.3 %; cSSTI, 81.0 %; osteomyelitis, 77.7 %; foreign body/prosthetic infection (FBPI), 75.9 %; endocarditis, 75.4 %; and bacteremia, 69.5 %). The clinical success rate was 79.1 % in patients with Staphylococcus aureus infections (MRSA, 78.1 %). An increasing trend of high-dose daptomycin (>6 mg/kg/day) prescribing pattern was observed over time. Clinical success rates were higher with high-dose daptomycin treatment for endocarditis and FBPI. Adverse events (AEs) and serious AEs possibly related to daptomycin therapy were reported in 628 (5.4 %) and 133 (1.2 %) patients, respectively.ConclusionsThe real-world data showed that daptomycin was effective and safe in the treatment of various Gram-positive infections, including those caused by resistant pathogens, across wide geographical regions.
Highlights
Pooled data from two large registries, Cubicin® Outcomes Registry and Experience (CORE; United States of America (USA)) and European Cubicin® Outcomes Registry and Experience (EU-CORE; Europe, Latin America, and Asia), were analyzed to determine the characteristics and clinical outcomes of daptomycin therapy in patients with Gram-positive infections across wide geographical regions
Treatment choices are increasing for Gram-positive infections, including those caused by resistant pathogens
Daptomycin is approved in adult patients for the treatment of complicated skin and soft tissue infection, right-sided infective endocarditis (RIE) due to S. aureus, and bacteremia associated with cSSTI or RIE (6 mg/kg/day) [17, 18]
Summary
Pooled data from two large registries, Cubicin® Outcomes Registry and Experience (CORE; USA) and European Cubicin® Outcomes Registry and Experience (EU-CORE; Europe, Latin America, and Asia), were analyzed to determine the characteristics and clinical outcomes of daptomycin therapy in patients with Gram-positive infections across wide geographical regions. Other antibiotics with MRSA activity such as ceftaroline, ceftobiprole, telavancin, and tigecycline represent alternatives for the treatment of infections caused by drug-resistant Grampositive pathogens [8]. Daptomycin is a cyclic lipopeptide with rapid bactericidal activity against a wide range of Gram-positive pathogens such as methicillin-susceptible S. aureus (MSSA), MRSA, and VRE [15, 16]. Several study reports showed that high-dose daptomycin is increasingly used in patients with various deep seated infections and in those failing treatment with other antibiotics [23,24,25,26]. Randomized controlled trials have shown a favorable safety and efficacy profile of daptomycin in patients with S. aureus bacteremia, endocarditis, and osteomyelitis/orthopedic device infections [30,31,32]
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