title: Retrospective case-control analysis of patients with staphylococcal infections receiving daptomycin or glycopeptide therapy.
abstract: Glycopeptides have been considered the antimicrobials of choice for serious meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-resistant coagulase-negative staphylococci (MR-CoNS) infections for several years. Daptomycin is a new option for the treatment of these infections, including those exhibiting reduced susceptibility to glycopeptides. The aim of this study was to compare glycopeptides and daptomycin for the treatment of infections caused by MRSA or MR-CoNS. Data for 106 patients with bloodstream infections (bacteraemia or infective endocarditis) or skin and soft-tissue infections (SSTIs) were retrospectively reviewed, of which 43 were treated with daptomycin (DAP group) and 63 were treated with vancomycin or teicoplanin (GLYCO group). Patients included in the two comparison groups were homogeneous in terms of age, risk factors and clinical severity. Aetiology was mainly represented by MRSA in both groups, followed by various species of MR-CoNS. Daptomycin was used more frequently in patients with central venous catheter-associated bacteraemia or pacemaker-associated infection. Patients with SSTIs included in the GLYCO group had a longer mean duration of antibiotic therapy (18.2 days vs. 14.6 days; P=0.009) and a longer mean length of hospital stay (28.2 days vs. 19.6 days; P=0.01) compared with those included in the DAP group. A longer mean duration of antibiotic therapy was also observed in patients with bloodstream infections receiving glycopeptide therapy (25.6 days vs. 18 days; P=0.004). In conclusion, the good clinical efficacy of daptomycin is associated with a more rapid resolution of the clinical syndrome and a reduced length of hospitalisation. This latter aspect may have important pharmacoeconomic implications, promoting the use of daptomycin in the clinical setting.
authors: Department of Public Health and Infectious Diseases, Policlinico Umberto I, Sapienza University of Rome, Viale dell'Università 37, Rome, Italy. marcofalc@libero.it
authors: Marco
authors: M
authors: Falcone
authors: Alessandro
authors: A
authors: Russo
authors: Maria Elena
authors: ME
authors: Pompeo
authors: Antonio
authors: A
authors: Vena
authors: Laura
authors: L
authors: Marruncheddu
authors: Antonio
authors: A
authors: Ciccaglioni
authors: Paolo
authors: P
authors: Grossi
authors: Carlo
authors: C
authors: Mancini
authors: Andrea
authors: A
authors: Novelli
authors: Stefania
authors: S
authors: Stefani
authors: Mario
authors: M
authors: Venditti
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D016022:Case-Control Studies; D003030:Coagulase / Q000378:metabolism; D017576:Daptomycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006020:Glycopeptides / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase; D006020:Glycopeptides; D017576:Daptomycin