Use of Daptomycin to Treat Infections With Methicillin-Resistant Staphylococcus aureus Isolates Having Vancomycin Minimum Inhibitory Concentrations of 1.5 to 2 µg/mL

Abstract

Current published evidence indicates daptomycin may be an acceptable alternative to vancomycin for MRSA infections, especially bacteremia, involving isolates with vancomycin MIC values of 1.5 to 2 µg/mL. Additional evidence is needed to fully elucidate daptomycin utility in this area.

Avoiding the Perfect Storm: The Biologic and Clinical Case for Reevaluating the 7-Day Expectation for Methicillin-Resistant Staphylococcus aureus Bacteremia Before Switching Therapy

“…A comparison of 60-day mortality between vancomycinand daptomycin-treated patients revealed a higher probability of survival in the daptomycin-treated group (P = .02). McDaneld et al [21] conducted a meta-analysis of 7 retrospective clinical studies evaluating the clinical outcomes of daptomycin used as first-line or salvage therapy for MRSA infections, compared with vancomycin. Daptomycin therapy in bacteremic patients led to lower 60-day (8% vs 20%; P = .046) and 30-day (3.5% vs 12.9%; P = .047) mortality rates and increased treatment success (68.6% vs 43.1% [P = .008]).…”

The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection

“…Concerns have been expressed, however, about the efficacy of glycopeptides for managing MRSA infections [345][346][347][348][349] and the nephrotoxicity of these agents [350][351][352]. Among other agents with activity against MRSA [345,[353][354][355], the task force considered linezolid and daptomycin to be the most reasonable alternatives. Linezolid is at least as effective as vancomycin for the management of infections from MRSA, with some data suggesting superiority [344,348,[355][356][357][358].…”

“…There are some observational data describing successful use of linezolid to treat patients with IAI from MRSA [336]. Daptomycin, likewise, appears to be equivalent to vancomycin for the management of serious MRSA infections [337,354,359] and could be used to treat patients with IAI from MRSA.…”

“…Thus, use of different agents for first-line therapy of MRSA infections should also be considered [353][354][355] Both linezolid and daptomycin appear to have efficacy at least equivalent to vancomycin for managing serious infections from this organism and have been used successfully in patients with IAI [344,348,[354][355][356][357][358][359]. Based on these data, the task force believes that vancomycin, teicoplanin (where available), linezolid, and daptomycin are options for the empiric treatment of patients with HA-IAI when MRSA is a suspected pathogen (Table 10).…”

Envelope Structures of Gram-Positive Bacteria

“…2010). In addition, other classes of antibiotics have been developed to treat MRSA, including daptomycin, tedizolid, linezolid, and the glycopeptide analog oritavancin (Hall and Michaels 2015; Holmes and Howden 2014; Leach et al 2011; McDaneld et al 2013; Mitra et al 2015). …”