Daptomycin in bone and joint infections: a review of the literature

Abstract

Introduction To review the pharmacology, pharmacokinetics, efficacy, and safety of daptomycin, a novel antibiotic for the treatment of bone and joint infections, a literature search of relevant articles was conducted. Materials and methods A PubMed/MEDLINE search (1990–April 2008) to identify relevant English-language literature was conducted. Search terms included bone and joint infection, osteomyelitis, daptomycin, and methicillin-resistant Staphylococcus aureus (MRSA). Additional articles were identified by reviewing the bibliographies of articles cited. Programs and abstracts from infectious disease meetings were searched, and prescribing information of antibiotics indicated for bone and joint infections consulted. All articles identified from data sources published in English were evaluated. Results Caused primarily by Gram-positive pathogens such as S. aureus and, to a lesser extent, Enterococcus faecalis, bone and joint infections are difficult to treat successfully. Surgical intervention and prolonged courses of antibiotics are frequently required, and failure of first-line antibiotic therapy is common. The emergence of S. aureus strains with reduced susceptibility to vancomycin, the longstanding gold standard for bone and joint infections, has complicated the clinical scenario. Few randomized trials comparing the efficacy of different antibiotics for bone and joint infections exist. Daptomycin, a novel intravenous lipopeptide antibiotic, has shown potent in vitro activity against a broad spectrum of Gram-positive bacteria, including many resistant pathogens commonly associated with bone and joint infections such as MRSA and vancomycin-resistant E. faecalis. Early clinical investigation of daptomycin in bone and joint infections unresponsive to antibiotics, such as vancomycin, has found a cure rate of approximately 80%, with a low incidence of adverse events and drug resistance. Conclusion Further studies are warranted to determine if limited clinical evidence, described in individual case reports and a daptomycin-specific retrospective registry, suggests daptomycin is a promising option for patients with bone and joint infections such as MRSA osteomyelitis.

In vitro susceptibility of Staphylococcus aureus and Staphylococcus epidermidis isolated from prosthetic joint infections

“…alternative to vancomycin because of its high level of antimicrobial and antibiofilm activity, as previously reported. 10,32 According to our data, daptomycin not only inhibited all the tested strains but also showed high bactericidal activity for both bacterial species (77.78% for S. aureus and 78.95% for S. epidermidis). These results are in accordance with those of other studies.…”

“…8,9 For this reason, other antibiotics have recently been considered as alternatives to vancomycin. [10][11][12][13][14][15] Despite these facts, antimicrobial susceptibility remains extremely variable among these microorganisms, making it necessary to perform individual susceptibility studies for each strain to select the best antibiotic combination for treatment. 16 The aim of this study was to evaluate the in vitro susceptibility pattern of S. aureus and S. epidermidis strains isolated from retrieved prosthetic joint implants against antibiotics commonly used in the treatment of PJI.…”

Treatment Options and Outcomes of Vancomycin-Resistant Enterococcus in prosthetic joint infections: Case Report and Potential Implications for Military Cases

“…Daptomycin has been shown to have bactericidal activity in treating Gram-positive orthopedicrelated infections at high doses (4 -6 mg/kg/day) (12,18). While substantial reports exist on its use in PJI caused by MRSA and non-resistant Enterococcus, daptomycin has been used infrequently to treat VRE-associated PJI (12,18).…”

Daptomycin Experience Between Years 2009-2013: Review of 139 Cases

“…ABD'de 6 merkezde yapılan retrospektif bir incelemede en sık osteomiyelit etkeni MRSA olarak bulunmuş (%64) ve hastaların %52'si tedavi başında daptomisin ile beraber vankomisin tedavisi almış. Bu çalışmada tedavi sonu kür %55, iyileşme %34 ve tedavi başarısızlığı %10 olarak tespit edilmiştir (n= 29) [16] . Bu çalışmada ortanca tedavi süresi 42 (18-63) gün olarak hesaplanmıştır.…”