title: Daptomycin use in patients with osteomyelitis: a preliminary report from the EU-CORE(SM) database.
abstract: BACKGROUND
  Osteomyelitis is a complex and heterogeneous group of infections that require surgical and antimicrobial interventions. Because treatment failure or intolerance is common, new treatment options are needed. Daptomycin has broad Gram-positive activity, penetrates bone effectively and has bactericidal activity within biofilms. This is the first report on clinical outcomes in patients with osteomyelitis from the multicentre, retrospective, non-interventional European Cubicin(®) Outcomes Registry and Experience (EU-CORE(SM)), a large database on real-world daptomycin use.
  
  
  METHODS
  In total, 220 patients were treated for osteomyelitis; the population was predominantly elderly, with predisposing baseline conditions such as diabetes and chronic renal/cardiac diseases.
  
  
  RESULTS
  Most patients (76%) received prior antibiotic treatment, and first-line treatment failure was the most frequent reason to start daptomycin. Common sites of infection were the knee (22%) or hip (21%), and the most frequently isolated pathogens were Staphylococcus aureus (33%) and coagulase-negative staphylococci (32%). Overall, 52% of patients had surgery, 55% received concomitant antibiotics and 29% received a proportion of daptomycin therapy as outpatients. Clinical success was achieved in 75% of patients. Among patients with prosthetic device-related osteomyelitis, there was a trend towards higher success rates if the device was removed. Daptomycin was generally well tolerated.
  
  
  CONCLUSIONS
  This analysis suggests that daptomycin is an effective and well-tolerated treatment option for osteomyelitis and highlights the importance of optimal surgical intervention and appropriate microbiological diagnosis for clinical outcomes.
authors.affiliation: Brownlee Centre, Gartnavel General Hospital, Glasgow, UK. andrew.seaton@ggc.scot.nhs.uk
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Seaton
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Malizos
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Viale
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Gargalianos-Kakolyris
authors.forename: Teresa
authors.initials: T
authors.lastname: Santantonio
authors.forename: Enzo
authors.initials: E
authors.lastname: Petrelli
authors.forename: Rashidkhan
authors.initials: R
authors.lastname: Pathan
authors.forename: Markus
authors.initials: M
authors.lastname: Heep
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Chaves
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017576:Daptomycin / Q000627:therapeutic use*; D005260:Female; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin
keywords: Gram-positive infections; bone infections; lipopeptides; non-interventional study; prosthetic device infections