Daptomycin for outpatient parenteral antibiotic therapy: a European registry experience

Abstract

A retrospective analysis of data from patients receiving daptomycin as outpatient parenteral antimicrobial therapy (OPAT) within the European Cubicin Outcomes Registry and Experience (EU-CORE(SM)) was performed. Of 4592 enrolled patients in 15 countries, 550 (12%) received daptomycin OPAT. Of these, 149 (27%) received daptomycin without hospital admission, 84% had significant underlying diseases and 44% were ≥65 years of age. Most frequently treated infections were complicated skin and soft-tissue infections (28%), osteomyelitis (17%), foreign body/prosthetic infections (15%) and endocarditis (14%). In patients with culture results available, Staphylococcus aureus and coagulase-negative staphylococci were the most commonly isolated primary pathogens [n = 218 (46%) and n = 102 (21%), respectively]. Daptomycin was typically used at doses of 6 mg/kg (n = 210; 38%) and 4 mg/kg (n = 160; 29%), with concomitant antibiotics used in 41%. The median treatment duration was 22 days (range 1-300 days), with a median of 13 OPAT days (range 1-290 days). Overall clinical success was observed in 89%, with high success rates across the wide range of infections, including those caused by meticillin-resistant and meticillin-susceptible S. aureus (88% and 90%, respectively). Daptomycin exhibited a favourable safety profile; 3.1% of patients discontinued treatment owing to an adverse event. These data demonstrate that daptomycin is effective and well tolerated in the treatment of a wide range of Gram-positive infections in the outpatient setting. Ease of administration of daptomycin, via a daily 2-min injection, and its efficacy and safety combine to make it an attractive treatment option for OPAT.

Daptomycin in the Clinical Setting: 8-Year Experience with Gram-positive Bacterial Infections from the EU-CORESM Registry

“…Overall, daptomycin used either as first- or second-line therapy was associated with high clinical success rates. The data demonstrated a favorable effectiveness and safety profile of daptomycin in the real-world setting, expanding on the results from randomized clinical trials and analyses of interim data from EU-CORE [ 20 – 22 ]. Patients from many sites across the 18 countries in Europe, Latin America, and Asia were enrolled in EU-CORE, allowing for the inclusion of a wide spectrum of infections and microbiologic data to be studied.…”

Real-World Treatment of Enterococcal Infections with Daptomycin: Insights from a Large European Registry (EU-CORE)

“…Patients who received daptomycin as part of a controlled clinical trial were not eligible for inclusion in the study. Interim results of the EU-CORE registry were previously reported [ 22 , 23 ].…”

General principles of antimicrobial therapy for infective endocarditis

“…В связи с этим в течение последних лет изучается возможность перорального применения антимикробных препаратов у пациентов с ИЭ. Чаще всего в таких случаях назначают аминопенициллины (амоксициллин), фторхинолоны (ципрофлоксацин), оксазолидиноны (линезолид) и рифампицин [14,15]. При этом следует отметить, что в случае стафилококковой природы инфекционного процесса пероральный путь ведения антимикробных препаратов возможен исключительно при наличии ответа на двухнедельную парентеральной терапию [8]…”