title: [Current treatment of Gram-positive infections: from experimental models to clinical experience after approval of new drugs].
abstract: The use of modern antibiotics in clinical practice for indications that seem highly appropriate but are not approved is hampered by the lack of clinical trials. When there are no valid alternatives, the use of off-label antimicrobials is based on data obtained from microbiological activity, pharmacokinetic and pharmacodynamic profiles, experimental models, case reports and small series. Experimental models provide information on indications not investigated in clinical trials and can partly solve the inability of new drugs to demonstrate superiority over comparators. Several experimental models in osteomyelitis and implant-associated infections by methicillin-resistant Staphylococcus aureus have demonstrated that daptomycin at high doses and in combination with rifampicin have produced superior results to comparators.
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Central de la Defensa Gómez Ulla, Madrid, España. josebarberan@teleline.es
authors.forename: José
authors.initials: J
authors.lastname: Barberán
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects; D002986:Clinical Trials as Topic; D017576:Daptomycin / Q000494:pharmacology / Q000627:therapeutic use; D017277:Drug Approval; D004353:Drug Evaluation, Preclinical; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D023421:Models, Animal; D010019:Osteomyelitis / Q000188:drug therapy; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D011817:Rabbits; D051381:Rats; D017208:Rats, Wistar; D013203:Staphylococcal Infections / Q000188:drug therapy; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D017576:Daptomycin