title: [Role of daptomycin in the empirical and directed therapy of infections caused by Gram-positive bacteria in the critically ill patient].
abstract: Infections caused by Gram-positive bacteria are a serious problem and is associated with high mortality. Among them, we should highlight those caused by methicillin-resistant Staphylococcus aureus (MRSA). Primary bacteremia, catheter-related bloodstream infections and constitute the main presentations. Vancomycin has traditionally been the treatment of choice for these infections, but its activity is not satisfactory especially in cases of MRSA with minimum inhibitory concentration (MIC) > 1 mg/L. Daptomycin is a lipopeptide antibiotic active against Gram-positive bacteria including MRSA and glycopeptide-resistant Enterococcus spp.It is worth mentioning that daptomycin is rapidly bactericidal against methicillin-sensitive S. aureus, more potent than vancomycin and at least as active as isoxazole penicillins. This article discusses the role of this antibiotic in the empirical treatment of infections and directed by Gram-positive bacteria affecting critically ill patients.
authors.affiliation: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocio, Sevilla, Spain. jgarnachom@telefonica.net
authors.forename: J
authors.initials: J
authors.lastname: Garnacho-Montero
authors.forename: R
authors.initials: R
authors.lastname: Amaya-Villar
authors.forename: M L
authors.initials: ML
authors.lastname: Gómez-Grande
authors.forename: V
authors.initials: V
authors.lastname: Jerez
authors.forename: L
authors.initials: L
authors.lastname: Lorente-Ramos
authors.forename: A
authors.initials: A
authors.lastname: Loza
authors.forename: A
authors.initials: A
authors.lastname: Martínez
authors.forename: J C
authors.initials: JC
authors.lastname: Pozo
authors.forename: R
authors.initials: R
authors.lastname: Sierra
authors.forename: J
authors.initials: J
authors.lastname: Pomares
authors.forename: M V
authors.initials: MV
authors.lastname: de la Torre
authors.forename: C
authors.initials: C
authors.lastname: Ortiz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care; D016638:Critical Illness; D017576:Daptomycin / Q000494:pharmacology / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D006094:Gram-Positive Bacteria / Q000187:drug effects; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology; D014640:Vancomycin / Q000627:therapeutic use; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D017576:Daptomycin