This study was conducted to assess clinical and cost outcomes associated with the use of
daptomycin. This objective was addressed through a consecutive patient chart review of the first 50 inpatients treated with
daptomycin. Type of
infection, identity of isolated pathogens, prior
therapy, duration of
therapy, length of hospitalization, cost of
antibiotics, adverse events, and outcomes were evaluated. The analysis showed that mean patient age was 64 y, and mean length of hospitalization was 9.2 d. A total of 62% of patients had confirmed methicillin-resistant Staphylococcus aureus
infection. The mean duration of
daptomycin therapy was 7.5 d; however, in patients given treatment for complicated skin and skin structure
infections, the mean
duration of therapy was 6.1 d (n=15) and 7.1 d (n=16) for first- and second-line
daptomycin therapy, respectively. The average course of
daptomycin cost $727 (n=38) and $390 (n=11), respectively, in the subset of patients with
renal insufficiency. In patients who did not respond to prior
antibiotic treatment for a
Gram-positive bacterial infection (n=26), the mean duration of prior
therapy with
antibiotics was 6.0 d and the cost was $287. For patients who were transitioned to outpatient
daptomycin therapy (n=14), hospital charges were reduced by an estimated $102,340. In 48 patients (96%),
infection was resolved with
daptomycin therapy.
Daptomycin was effective in resolving Grampositive
infection in this aged patient population. Earlier identification of
antibiotic failure, first-line use of
daptomycin in patients with complicated skin and skin structure
infections, and outpatient
daptomycin therapy provided cost savings and improved clinical outcomes at this facility.