Daptomycin and combination daptomycin-ceftaroline as salvage therapy for persistent methicillin-resistant <i>Staphylococcus aureus</i> bacteremia

Cortés-Penfield, Nicolás W; Oliver, Nora; Hunter, Andrew; Rodriguez‐Barradas, Maria C.

doi:10.1080/23744235.2018.1448110

Cited by 24 publications

(16 citation statements)

References 9 publications

(9 reference statements)

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“…Another large series of 12 patients treated with DAP/CPT saw a significantly higher mortality rate of 50%. 20 Regarding experience with VAN-based therapy, our results are similar to that reported in the largest available case series of patients treated with VAN/CPT. 18 In that group, all patients had multifocal infections (100%, n = 5), most had persistent bacteremia (80%, n = 4), endocarditis was common (40%, n = 2), and clinical success was realized in the majority (80%, n = 4).…”

Section: Discussionsupporting

confidence: 86%

“…Clinical success has been reported with CPT in combination with both DAP and VAN for treating MRSA-B; however, no comparative studies are available or describe a single center's experience with both regimens. [12][13][14][18][19][20][21][22] We are interested in the potential for these regimens to improve clinical outcomes in patients with MRSA-B. Here, we report on our singlecenter experience using DAP/CPT or VAN/CPT as treatment options for complicated MRSA bacteremia following monotherapy failure.…”

Section: Introductionmentioning

confidence: 99%

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Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure

Hornak

Anjum

Reynoso

2019

Therapeutic Advances in Infection

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Background: Methicillin-resistant Staphylococcus aureus bacteremia (MRSA-B) may fail to improve with standard monotherapy, particularly in patients with multifocal infection, incomplete source control, or persistent bacteremia. Synergy observed in vitro between ceftaroline (CPT) and daptomycin (DAP) or vancomycin (VAN) may translate into clinical benefit. Here, we describe our experience with DAP/CPT and VAN/CPT for complicated MRSA-B after monotherapy failure. Methods: Single-center, retrospective review of consecutive patients treated with DAP/CPT or VAN/CPT for MRSA-B after monotherapy failure from 1 January 2016 to 30 November 2018. Results: We identified 11 instances of combination therapy in 10 patients (DAP/CPT = 6, VAN/CPT = 5) with 1 patient receiving VAN/CPT followed by DAP/CPT. Rates of multifocal infection, incomplete source control, persistent bacteremia, and infective endocarditis were high (100%, 80%, 60%, and 60%, respectively). Combination therapy was initiated most commonly for persistent bacteremia (60%). When patients were persistently bacteremic, median preceding duration was 13 days and median time to clearance was 3 days. Total microbiologic cure rate was 100%. There were zero instances of bacteremia relapse at 30 days (30D) or 60 days (60D). All-cause 30D and 60D mortality rates were 11.1% and 33.3%, respectively. Conclusions: Combination therapy demonstrated success in diverse cases of refractory MRSA-B, including instances of persistent bacteremia paired with incomplete source control. Optimal timing and therapeutic cadence for combination therapy remain unclear. Our findings suggest that DAP/CPT and VAN/CPT can be considered for complicated MRSA bacteremia when other treatment options fail or are unavailable. We propose persistent bacteremia with incomplete source control to be a clinical niche particularly worthy of further investigation.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure

Hornak

Anjum

Reynoso

2019

Therapeutic Advances in Infection

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“…In our study, CT subjects had higher severity of illness and more complex infections than MT subjects, and were therefore at a high risk for mortality. As demonstrated in previous studies, high-risk MRSA BSI patients benefit the most from CT when administered early in the treatment course (i.e., within 72 h) [8,36,39]. This underscores the importance of early BL addition to achieve timely bacterial eradication (i.e., 3--4 days) and hence avoiding the ''perfect storm'' [29].…”

Section: Discussionmentioning

confidence: 54%

Monotherapy with Vancomycin or Daptomycin versus Combination Therapy with β-Lactams in the Treatment of Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections: A Retrospective Cohort Analysis

et al. 2020

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) are associated with high morbidity and mortality. More in vitro, in vivo, and clinical data suggest that vancomycin (VAN) or daptomycin (DAP) combination therapy with b-lactams (BL) improves outcomes of MRSA infections. We hypothesize that BL combination with VAN or DAP would reduce the odds of clinical failure compared to VAN or DAP monotherapy. Methods: A retrospective cohort study of adult patients C 18 years treated with VAN or DAP for MRSA BSI from 2006 to 2019 at Detroit Medical Center. Combination therapy (CT) was defined as VAN or DAP plus any BL for C 24 h within 72 h of index culture. Monotherapy (MT) was defined as C 72 h VAN or DAP within 72 h of index culture and no BL for C 24 h up to 7 days following VAN/DAP initiation. Primary outcome was composite endpoint of clinical failure defined as: (1) 30-day mortality, (2) 60-day recurrence, or (3) persistent bacteremia (PB). PB was defined as bacteremia [ 5 days. Multivariable logistic regression was used to evaluate the association between CT and the primary outcome. Results: Overall, 597 patients were included in this analysis, 153 in the MT group and 444 in the CT group. CT was independently associated with reduced odds of clinical failure (adjusted odds ratio, 0.523; 95% confidence interval, 0.348-0.787). The composite endpoint was Enhanced Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare. 11973288.

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“…It may be a worthwhile addition to daptomycin in refractory cases. In an effort to study further daptomycin-ceftaroline synergism, Cortes-Penfeld and coworkers [33] performed a retrospective chart review of patients with MRSAB after receiving treatment with vancomycin in combination with ceftaroline. Seventeen patients were included in the study: The first group consisted of four patients who received the combination as a second line therapy.…”

Section: Specific Populationsmentioning

confidence: 99%

A Mini-Review on Ceftaroline in Bacteremia Patients with Methicillin-Resistant Staphylococcus aureus (MRSA) Infections

Lounsbury

Mina

et al. 2019

Antibiotics

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Objective: The objective of this review is to describe the outcomes of patients treated with ceftaroline in the non-Food and Drug Administration (FDA) approved indication of methicillin-resistant Staphylococcus aureus (MRSA) infections in both pediatric and adult populations. Data sources: A systematic overview was conducted by searching PubMed, Medline, and The Cochrane Library up to January 2019. Study selection and data extraction: All English-language clinical trials and case reports related to the efficacy of ceftaroline in new, not-yet-approved FDA indications in MRSA infections in pediatric or adult populations. Data synthesis: In the case of MRSA bacteremia (MRSAB) infections, three different randomized studies in pediatric patients showed effectiveness of ceftaroline. When used in the case of adult populations with MRSA bacteremia, a small trial of 16 patients showed 50% clinical success in patients with acute bacterial skin and skin structure infections versus 63% clinical success in patients with community-acquired bacterial pneumonia. Another case series of six refractory case reports showed 50% clinical success of ceftaroline in patients with MRSA. Conclusions: Although there are few case reports and limited data to date, ceftaroline fosamil should continue to be studied as an alternative therapy in MRSA infections in both pediatric and adult populations. Clinical success rates of ceftaroline were, in most cases, considered high when treating patients with MRSA infection. More clinical trials need to be studied. In the specific case of MRSA bacteremia, the treatment options remain few and ceftaroline should be extensively studied for the salvage treatment of MRSAB.

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Daptomycin and combination daptomycin-ceftaroline as salvage therapy for persistent methicillin-resistant Staphylococcus aureus bacteremia

Cited by 24 publications

References 9 publications

Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure

Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure

Monotherapy with Vancomycin or Daptomycin versus Combination Therapy with β-Lactams in the Treatment of Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections: A Retrospective Cohort Analysis

A Mini-Review on Ceftaroline in Bacteremia Patients with Methicillin-Resistant Staphylococcus aureus (MRSA) Infections

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