title: Daptomycin for outpatient parenteral antibiotic therapy: a European registry experience.
abstract: A retrospective analysis of data from patients receiving daptomycin as outpatient parenteral antimicrobial therapy (OPAT) within the European Cubicin Outcomes Registry and Experience (EU-CORE(SM)) was performed. Of 4592 enrolled patients in 15 countries, 550 (12%) received daptomycin OPAT. Of these, 149 (27%) received daptomycin without hospital admission, 84% had significant underlying diseases and 44% were ≥65 years of age. Most frequently treated infections were complicated skin and soft-tissue infections (28%), osteomyelitis (17%), foreign body/prosthetic infections (15%) and endocarditis (14%). In patients with culture results available, Staphylococcus aureus and coagulase-negative staphylococci were the most commonly isolated primary pathogens [n = 218 (46%) and n = 102 (21%), respectively]. Daptomycin was typically used at doses of 6 mg/kg (n = 210; 38%) and 4 mg/kg (n = 160; 29%), with concomitant antibiotics used in 41%. The median treatment duration was 22 days (range 1-300 days), with a median of 13 OPAT days (range 1-290 days). Overall clinical success was observed in 89%, with high success rates across the wide range of infections, including those caused by meticillin-resistant and meticillin-susceptible S. aureus (88% and 90%, respectively). Daptomycin exhibited a favourable safety profile; 3.1% of patients discontinued treatment owing to an adverse event. These data demonstrate that daptomycin is effective and well tolerated in the treatment of a wide range of Gram-positive infections in the outpatient setting. Ease of administration of daptomycin, via a daily 2-min injection, and its efficacy and safety combine to make it an attractive treatment option for OPAT.
authors.affiliation: Brownlee Centre for Infectious Disease, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK. andrew.seaton@ggc.scot.nhs.uk
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Seaton
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Gonzalez-Ramallo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Prisco
authors.forename: M
authors.initials: M
authors.lastname: Marcano-Lozada
authors.forename: A
authors.initials: A
authors.lastname: Gonzalez-Ruiz
authors.forename: B
authors.initials: B
authors.lastname: Gallegos
authors.forename: F
authors.initials: F
authors.lastname: Menichetti
authors.forename: J
authors.initials: J
authors.lastname: Loeffler
authors.forename: Kamel
authors.initials: K
authors.lastname: Bouylout
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Chaves
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D017576:Daptomycin / Q000008:administration & dosage*; D005060:Europe; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin