Outcomes with daptomycin versus standard therapy for osteoarticular infections associated with Staphylococcus aureus bacteraemia
Open Access
- 13 November 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Antimicrobial Chemotherapy
- Vol. 61 (1), 177-182
- https://doi.org/10.1093/jac/dkm437
Abstract
To evaluate the clinical characteristics, treatment and outcomes of patients with osteoarticular infections (OAIs) associated with Staphylococcus aureus bacteraemia (SAB). The clinical characteristics and outcomes for patients with OAI were described using a post hoc analysis of an open label, randomized trial comparing daptomycin with standard therapy (vancomycin or anti-staphylococcal penicillin with initial gentamicin) for the treatment of SAB. OAI occurred in 32 of 121 patients (21 daptomycin and 11 standard therapy) with complicated SAB (18 septic arthritis, 9 vertebral osteomyelitis and 7 others). Two patients had osteomyelitis in more than one site. Success rates seen in two groups were as follows: vertebral osteomyelitis [3/5 (60%) daptomycin versus 0/2 (0%) comparator], septic arthritis [7/11 (64%) versus 3/5 (60%)], sternal osteomyelitis [3/3 (100%) versus 1/2 (50%)] and long bone osteomyelitis [0/1 (0%) versus 1/1 (100%)]. Success rates in both treatment groups improved with surgical therapy. Creatine phosphokinase elevations to >500 IU/L occurred in one patient on daptomycin who discontinued therapy, whereas renal impairment developed in three patients on standard therapy, two of whom discontinued therapy. Two patients treated with daptomycin and one patient on vancomycin had increases in S. aureus MICs to daptomycin and vancomycin, respectively. Three patients treated with daptomycin died following completion of therapy, with mortality attributed to multiple co-morbid conditions and inadequate debridement of OAIs in these patients. No deaths were reported in the standard therapy group. Daptomycin may be considered an alternative to standard therapy in the treatment of patients with complicated SAB and OAI.Keywords
This publication has 9 references indexed in Scilit:
- Daptomycin versus Standard Therapy for Bacteremia and Endocarditis Caused byStaphylococcus aureusNew England Journal of Medicine, 2006
- Osteoarticular infections complicating infective endocarditis: A study of 30 cases between 1969 and 2002 in a tertiary referral centreScandinavian Journal of Infectious Diseases, 2006
- Use of daptomycin to treat drug-resistant Gram-positive bone and joint infectionsCurrent Medical Research and Opinion, 2005
- Efficacy and safety of tigecycline monotherapy compared with vancomycin plus aztreonam in patients with complicated skin and skin structure infections: Results from a phase 3, randomized, double-blind trialInternational Journal of Infectious Diseases, 2005
- Risk Factors For Hematogenous Complications of Intravascular Catheter--Associated Staphylococcus aureus BacteremiaClinical Infectious Diseases, 2005
- Successful Treatment of Chronic Bone and Joint Infections with Oral LinezolidClinical Orthopaedics and Related Research, 2004
- The Safety and Efficacy of Daptomycin for the Treatment of Complicated Skin and Skin-Structure InfectionsClinical Infectious Diseases, 2004
- Outcomes of osteomyelitis among patients treated with outpatient parenteral antimicrobial therapyAmerican Journal Of Medicine, 2003
- Linezolid (PNU-100766) versus Vancomycin in the Treatment of Hospitalized Patients with Nosocomial Pneumonia: A Randomized, Double-Blind, Multicenter StudyClinical Infectious Diseases, 2001