Daptomycin compared to standard therapy for the treatment of native valve endocarditis.

Abstract

INTRODUCTION:

In a recent randomized trial of Staphylococcus aureus bacteremia and native valve endocarditis, daptomycin was found not inferior to standard therapy. We summarized findings in the subgroup of patients with endocarditis according to the Duke criteria.

METHODS:

Patients were randomly assigned to receive daptomycin 6 mg/kg/day or standard therapy (vancomycin 1g every 12h or antistaphylococcal penicillin 2g every 4h, both with gentamicin 1mg/kg every 8h for the first 4 days). The primary end point was success in the modified intent-to-treat population 6 weeks after the end of therapy.

RESULTS:

Fifty-three patients were included: 35 with right-sided endocarditis (RIE) and 18 with left-sided endocarditis (LIE). The success rates in patients with RIE were similar between daptomycin and the comparator (42% vs 44%). Patients with RIE with septic pulmonary infarcts responded similarly to treatment with daptomycin and standard therapy (60% vs 67%). In the LIE population, treatment success rates were poor in both arms (11% vs 22%).

CONCLUSION:

Daptomycin is an efficacious and well-tolerated alternative to standard therapy in the treatment of RIE. Patients with LIE had a poor outcome regardless of the treatment received. Daptomycin is also effective in treating endocarditis with septic pulmonary infarcts.

• Authors: Zeina Kanafani, Helen Boucher, Vance Fowler, Christopher Cabell, Bruno Hoen, José M Miró, Tahaniyat Lalani, Gloria Vigliani, Marilyn Campion, Ralph Corey, Donald Levine
• Journal: Enfermedades infecciosas y microbiologia clinica (Enferm Infecc Microbiol Clin) Vol. 28 Issue 8 Pg. 498-503 (Oct 2010) ISSN: 1578-1852 [Electronic] Spain
• PMID: 20188444 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2009 Elsevier España, S.L. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Daptomycin

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Daptomycin (therapeutic use)
• Double-Blind Method
• Endocarditis, Bacterial (drug therapy)
• Female
• Humans
• Male
• Middle Aged