title: Real-World Treatment of Complicated Skin and Soft Tissue Infections with Daptomycin: Results from a Large European Registry (EU-CORE).
abstract: BACKGROUND
  The objective of this analysis was to describe in real-life settings the clinical outcomes and safety associated with daptomycin treatment in a cohort of patients with complicated skin and soft tissues infection (cSSTI).
  
  
  METHODS
  All patients with cSSTI who had received at least one dose of daptomycin between January 2006 and April 2012 were identified from a non-interventional, multicenter, retrospective registry (European Cubicin(®) Outcome Registry and Experience; EU-CORE(SM)).
  
  
  RESULTS
  Of the 6075 patients included in the EU-CORE registry, 1927 (31.7%) were diagnosed with cSSTI (male, 63.8%; median age, 63 years). The most frequent underlying diseases were cardiovascular disease (58.1%) and diabetes mellitus (40.7%). The most frequent cSSTIs included surgical site infections (34.9%), wound infections (20.2%) and diabetic foot infections (19.9%). The most frequently prescribed doses of daptomycin were 4 mg/kg/day (38.9%) and 6 mg/kg/day (35.2%). A total of 1126 (58.4%) patients received antibiotics prior to daptomycin treatment; treatment failure (53.7%) was the most common reason for switching to daptomycin. The majority of hospitalized patients (61.8%) were treated with concomitant antibiotics. Among patients with positive cultures, Staphylococcus aureus (51.9%; 673/1297) was the most common pathogen. The overall clinical success rate was 84.6%; for infections caused by S. aureus, the success rate was 87.2% (methicillin susceptible, 87.8%; methicillin resistant, 87.0%). Adverse events possibly related to daptomycin treatment were reported in 2.4% of patients and adverse events led to drug discontinuation in 2.4% of patients.
  
  
  CONCLUSIONS
  Daptomycin treatment resulted in high clinical success rates in patients with different cSSTI subtypes, the majority of whom having failed previous antibiotic therapy. Daptomycin was well tolerated and there were no new or unexpected safety findings.
authors.affiliation: Casa Di Cura Villa Berica, U.O. Medicina Vascolare e Piede Diabetico, Vicenza, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cogo
authors.affiliation: Darent Valley Hospital, Dartford, UK.
authors.forename: Armando
authors.initials: A
authors.lastname: Gonzalez-Ruiz
authors.affiliation: Novartis Healthcare Pvt. Ltd., Hyderabad, India.
authors.forename: Rashidkhan
authors.initials: R
authors.lastname: Pathan
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. kamal.hamed@novartis.com.
authors.forename: Kamal
authors.identifier: http://orcid.org/0000-0003-1896-9736
authors.initials: K
authors.lastname: Hamed
keywords: Complicated skin and soft tissue infection; Daptomycin; EU-CORE; Gram-positive infections; Staphylococci