title: Clinical Experience with Daptomycin for the Treatment of Gram-positive Infections in Children and Adolescents.
abstract: BACKGROUND
  This subgroup analysis of the European Cubicin Outcomes Registry Experience evaluated the safety and effectiveness of daptomycin in children and adolescent patients (<18 years).
  
  
  METHODS
  Clinical outcomes at the end of therapy were assessed as success (cured or improved), failure or nonevaluable. Safety was assessed for up to 30 days post treatment.
  
  
  RESULTS
  Eighty-one children and adolescent patients were included in this study. The most common primary infections were bacteremia (19.8%), complicated skin and soft-tissue infection (18.5%), osteomyelitis (13.6%), endocarditis (12.3%), foreign body/prosthetic infection (12.3%), uncomplicated skin and soft-tissue infection (9.9%) and other (13.6%). Daptomycin doses ranged from 4 to >10 mg/kg/day. Median duration of therapy was 12.5 (interquartile range, 7-25; mean, 16.7; standard deviation, 12.8) days. Staphylococcus aureus (46.7%) was the most commonly isolated pathogen (23.8% methicillin-resistant S. aureus). Forty-nine (60.5%) patients completed daptomycin therapy without further antibiotics, 27 (33.3%) switched to another antibiotic, 4 (4.9%) discontinued because of adverse events (AEs) and 1 (1.2%) discontinued because of other reason. Overall, 75 (92.6%; 95% confidence interval: 95.2-100.0%) patients achieved clinical success; 39 of 41 (95.1%) patients receiving daptomycin monotherapy and 36 of 40 (90.0%) patients receiving concomitant antibiotics. Six (7.4%) patients reported AEs, including 1 patient with increased blood creatine phosphokinase. Three (3.7%) patients had serious AEs; 1 (1.2%) had a serious AE possibly related to daptomycin.
  
  
  CONCLUSIONS
  Daptomycin, alone or combined with other antibiotics and/or surgery, demonstrated high clinical success rates against a wide variety of infections and was well tolerated in children and adolescents.
authors: From the *First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece; †Department of Orthopaedic Surgery, University of Thessalia, Larissa, Greece; ‡Oncology National Scientific Center, Moscow, Russia; §A.O.R.N. Monaldi-U.O.C. Medicina Infettivologica e dei Trapianti, Napoli, Italy; ¶Biostatistics and Statistical Sciences, Novartis Healthcare Pvt. Ltd., Hyderabad, India; and ‖Global Medical Affairs, Novartis Pharmaceuticals Corporation, East Hanover, NJ.
authors: Vassiliki
authors: V
authors: Syriopoulou
authors: Zoe
authors: Z
authors: Dailiana
authors: Nisichenko
authors: N
authors: Dmitriy
authors: Riccardo
authors: R
authors: Utili
authors: Rashidkhan
authors: R
authors: Pathan
authors: Kamal
authors: K
authors: Hamed
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017576:Daptomycin / Q000009:adverse effects / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin