title: A retrospective study of daptomycin use in a Paris teaching-hospital.
abstract: OBJECTIVE
  We retrospectively studied daptomycin use during 2010 at the Bichat-Claude-Bernard teaching-hospital (Paris) to observe the evolution of daptomycin prescriptions.
  
  
  METHODS
  Twenty-one patients were included and several parameters were documented: site of infection, bacterial species involved, reason for daptomycin use, dose and clinical outcome.
  
  
  RESULTS
  Ninety-five percent of daptomycin prescritions were off-label and most did not comply with local guidelines. Fifteen of the 21 patients were cured (71%), including 9 patients of the 12 with off-label and off-local recommendation prescriptions (75%). Osteitis and Enterococcus spp endocarditis were the new indications. Daptomycin was increasingly used at higher doses: 52% of our patients were given doses above 6mg/kg. Staphylococcus spp. was the most frequent pathogen responsible for infection is our patients, followed by Enterococcus spp.
  
  
  CONCLUSIONS
  Daptomycin use is likely to evolve because of its effectiveness in the treatment of osteitis, left-sided and Enterococcus spp. infective endocarditis. It is generally used at higher doses, which are well tolerated. However, therapeutic monitoring needs to be developed. The antibiotic commission of our hospital gave new recommendations for daptomycin use in 2011.
authors: Service de pharmacie clinique et des biomatériaux, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: F
authors: F
authors: Marc
authors: Service de pharmacie clinique et des biomatériaux, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: C
authors: C
authors: Esquirol
authors: Service de pharmacie clinique et des biomatériaux, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France. Electronic address: emmanuelle.papy@bch.aphp.fr.
authors: E
authors: E
authors: Papy
authors: Service des maladies infectieuses, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: P
authors: P
authors: Longuet
authors: Service de bactériologie, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: L
authors: L
authors: Armand-Lefevre
authors: Service des maladies infectieuses, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: C
authors: C
authors: Rioux
authors: Unité d'hygiène et de lutte contre les infections nosocomiales, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France.
authors: S
authors: S
authors: Diamantis
authors: Service des maladies infectieuses, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: C
authors: C
authors: Dumortier
authors: Service de bactériologie, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
authors: N
authors: N
authors: Bourgeois-Nicolaos
authors: Unité d'hygiène et de lutte contre les infections nosocomiales, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France.
authors: J-C
authors: JC
authors: Lucet
authors: Service de réanimation médicale et des maladies infectieuses, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: M
authors: M
authors: Wolff
authors: Service de pharmacie clinique et des biomatériaux, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors: P
authors: P
authors: Arnaud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D017576:Daptomycin / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D004696:Endocarditis / Q000188:drug therapy; D005260:Female; D019983:Guideline Adherence; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010000:Osteitis / Q000188:drug therapy; D010297:Paris; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin
keywords: Antibiotic; Antibiotique; Daptomycin; Daptomycine; Endocardite infectieuse; Infective endocarditis; Osteitis; Ostéite